FURP.ORG / PUBLIC DATA EXPLORER

AVERA ST ANTHONYS HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
AVERA ST ANTHONYS HOSPITAL (EIN 47-0463911)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201411349349306361
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T15:14:19-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 NICOLLET MALL STE 1300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470463911EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AVERA ST ANTHONY'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAVERNameControl
Phone4023365132Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 N 2ND STREETAddressLine1
CityONEILLCity
StateNEState
ZIP Code687631569ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRONALD CORKName
TitlePRESIDENT & CEOTitle
Phone4023365132Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM HUNWARDSEN CPAName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2014-05-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRONALD CORKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1300 N 2ND STREETAddressLine1
CityONEILLCity
StateNEState
ZIP Code687631569ZIPCode
FieldValueIRS element (for citing)
Gross Receipts35406043GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.AVERA-STA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1955YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionPROMOTION OF HEALTHActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees310TotalNbrEmployees
Total Nbr Volunteers26TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4866ContributionsGrantsPriorYear
Contributions Grants Current Year660100ContributionsGrantsCurrentYear
Program Service Revenue Prior Year35518116ProgramServiceRevenuePriorYear
Program Service Revenue CY34476391ProgramServiceRevenueCY
Investment Income Prior Year204504InvestmentIncomePriorYear
Investment Income Current Year264544InvestmentIncomeCurrentYear
Other Revenue Prior Year4680OtherRevenuePriorYear
Other Revenue Current Year5008OtherRevenueCurrentYear
Total Revenue Prior Year35732166TotalRevenuePriorYear
Total Revenue Current Year35406043TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY20000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year16509883SalariesEtcPriorYear
Salaries Etc Current Year16944510SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year17566232OtherExpensePriorYear
Other Expenses Current Year17387762OtherExpensesCurrentYear
Total Expenses Prior Year34076115TotalExpensesPriorYear
Total Expenses Current Year34352272TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1656051RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1053771RevenuesLessExpensesCY
Total Assets BOY39179797TotalAssetsBOY
Total Assets EOY38619867TotalAssetsEOY
Total Liabilities BOY14846454TotalLiabilitiesBOY
Total Liabilities EOY13308231TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY24333343NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY25311636NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAVERA 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29606809Expense
Grants20000Grants
Revenue34476391Revenue
DescriptionTO PROVIDE ACUTE PATIENT VISITS AND OUTPATIENT VISITS OF HEALTH CARE SERVICES. FOR THE YEAR ENDED JUNE 30, 2013, A TOTAL OF 2,781 PATIENT DAYS WERE RECORDED AND 276 NEWBORN PATIENT DAYS WERE RECORDED. CHARITY CARE IS ALSO PROVIDED BY THE FACILITY. FOR THE YEAR ENDED JUNE 30, 2013, THE FACILITY PROVIDED $584,987 IN CHARITY CARE, CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES FOR THE HOSPITAL BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO ITS PATIENTS.THE HOSPITAL ALSO PROVIDES COMMUNITY BENEFIT HEALTH ACTIVITIES AT LESS THAN OR AT NO COST TO SUPPORT THOSE IN THE AREA SERVED. 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 YEARS ENDED JUNE 30, 2013 AND 2012, SPECIFIC ACTIVITIES INCLUDED SENIOR RESOURCE PROGRAMS FOR BILLING ASSISTANCE; MEETING FACILITIES; PROGRAMS FOR PATIENTS AND FAMILIES SUFFERING FROM CANCER, DIABETES, BREATHING DISORDERS, MENTAL ILLNESS, AND OTHERS; ASSISTANCE TO HEALTH EDUCATORS; EMERGENCY HEALTHCARE PROVIDERS; WELLNESS PROGRAMS; REDUCED PRICED SPORTS MEDICINE SERVICES; AND OVERNIGHT HOUSING FOR FAMILIES OF HOSPITALIZED PATIENTS.Description
Total Program Service Expense29606809TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees310NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHAEL GARMANBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4023365132TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 N 2ND STREETAddressLine1
CityONEILLCity
StateNEState
ZIP Code687631569ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JIM RABE
CHAIR1.000.00XX000
ED NORTH
VICE-CHAIR1.000.00XX000
LISA LIND
SECRETARY/TREASURER1.000.00XX000
DR RICHARD FITCH
MEMBER1.000.00X000
RANDY HUPP
MEMBER1.000.00X000
JACK HURLEY
MEMBER1.000.00X000
DIAN EDWARDS
MEMBER1.000.00X000
DEB KELLY
MEMBER1.000.00X000
SISTER SHARON ANN HAAS OSB
MEMBER1.000.00X000
SISTER JANET SCHUMACHER PBVM
MEMBER1.000.00X000
SISTER MARY JAEGER PBVM
MEMBER1.0010.00X000
PETER LUENINGHOENER MD
PRES OF MED STAFF/PHYSICIAN1.000.00X000
RONALD CORK
PRESIDENT & CEO50.000.00XX021280012871
MICHAEL GARMAN
SEC/TREAS & SRVP FINANCE40.000.00X142187024662
EDWIN N COOK
RADIOLOGIST40.000.00540113034002X
MARK H MEYER
ORTHOPEDIC SURGEON40.000.00502704011726X
DEAN L BENSON
ORTHOPEDIC PA40.000.00137432019262X
CAMERON EVERITT
DIRECTOR OF PT/OT40.000.00162009022766X
ANTHONY AKAINDA
GENERAL SURGEON40.000.00355186030774X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1839631TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs212800TotalReportableCompFrmRltdOrgs
Total Other Compensation156063TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SACRED HEART HEALTH SERVICES
501 SUMMIT STYANKTONSD57078PHYSICIAN/MGMT SERVICES3746571
NORTH CENTRAL ANESTHESIA
PO BOX 359ONEILLNE68763ANESTHESIA SERVICES1051780
DOCS WHO CARE
1337 S FOUNTAIN DROLATHEKS66061ER STAFFING407385
AVERA HEALTH
3900 W AVERA DRIVE SUITE 300SIOUX FALLSSD57108E-SERVICES224544
AVERA MCKENNAN
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117E-EMERGENCY & E-PHARMACY171763
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Government Grants281750GovernmentGrants
All Other Contributions378350AllOtherContributions
Total Contributions660100TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENUE6221102904436829044368
CLINIC REVENUE62111049163174916317
OTHER REVENUE900099440482440482
CHANGE IN FDTN INTEREST9000997522475224
FieldValueIRS element (for citing)
Total Program Service Revenue34476391TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column34598TotalRevenueColumn
Exclusion$34,598ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real5008Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real5008Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column5008TotalRevenueColumn
Exclusion$5,008ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities187232Securities
Other42714Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities187232Securities
Other42714Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column229946TotalRevenueColumn
Exclusion$229,946ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column35406043TotalRevenueColumn
Related Or Exempt Function Income34476391RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$269,552ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total20000Total
Program Services20000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total161849Total
Management And General161849ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13056104Total
Program Services11749494ProgramServices
Management And General1306610ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total370199Total
Program Services322972ProgramServices
Management And General47227ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2477247Total
Program Services2039934ProgramServices
Management And General437313ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total879111Total
Program Services751269ProgramServices
Management And General127842ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total996006Total
Management And General996006ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18237Total
Management And General18237ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48001Total
Management And General48001ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5541944Total
Program Services5326114ProgramServices
Management And General215830ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total75657Total
Management And General75657ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1182394Total
Program Services286762ProgramServices
Management And General895632ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total90036Total
Management And General90036ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total455865Total
Program Services455865ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total239637Total
Program Services205437ProgramServices
Management And General34200ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total137692Total
Program Services70016ProgramServices
Management And General67676ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total527284Total
Program Services527284ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2383525Total
Program Services2383525ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total249190Total
Program Services249190ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES40745414074541
BAD DEBTS562984562984
EQUIPMENT LEASE AND REN54676749987446893
DUES AND SUBSCRIPTIONS940654144952616

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total163937Total
Program Services40099ProgramServices
Management And General123838ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total34352272Total
Program Services29606809ProgramServices
Management And General4745463ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3056732BOY
EOY4759800EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4633693BOY
EOY4073117EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1069524BOY
EOY1072849EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY68608BOY
EOY71965EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis40666348LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec19529889LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY22590151BOY
EOY21136459EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1206616BOY
EOY1223926EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5593815BOY
EOY5634115EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY103324BOY
EOY31652EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY226571BOY
EOY172809EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY630763BOY
EOY443175EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY39179797BOY
EOY38619867EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2333059BOY
EOY2262689EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY350000BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY11516845BOY
EOY11045542EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY646550BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14846454BOY
EOY13308231EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY24182843BOY
EOY25161136EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY150500BOY
EOY150500EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24333343BOY
EOY25311636EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39179797BOY
EOY38619867EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1053771ReconcilationRevenueExpenses
Reconciliation Unrealized Invest197522ReconciliationUnrealizedInvest
Reconcilation Other Changes-273000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance150500BeginningOfYearBalance
End Of Year Balance150500EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance150500BeginningOfYearBalance
End Of Year Balance150500EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance150500BeginningOfYearBalance
End Of Year Balance150500EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance150500BeginningOfYearBalance
End Of Year Balance150500EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance150500BeginningOfYearBalance
End Of Year Balance150500EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis770022OtherCostOrOtherBasis
Book Value770022BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis25615788OtherCostOrOtherBasis
Depreciation9745233Depreciation
Book Value15870555BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13121812OtherCostOrOtherBasis
Depreciation9344085Depreciation
Book Value3777727BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1158726OtherCostOrOtherBasis
Depreciation440571Depreciation
Book Value718155BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings21136459TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS4899256F
INVESTMENT IN FOUNDATION734859F
FieldValueIRS element (for citing)
Total Of Book Value Securities5634115TotalOfBookValueSecurities
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt34416131TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments197522NetUnrealizedGainsInvestments
Other Revenues-835984OtherRevenues
Revenue Not Rptd F990-638462RevenueNotRptdF990
Revenue Subtotal35054593RevenueSubtotal
Other Revenues Not Included351450OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt351450RevenueNotRptdOnFinStmt
Total Revenue Per Form99035406043TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt33789288TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal33789288ExpensesSubtotal
Other Expenses Not Included562984OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt562984ExpensesNotRptdOnFinStmt
Total Expenses Per Form99034352272TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE HOSPITAL'S ENDOWMENT CONSISTS OF A PORTION OF THEIR INTEREST IN THE NET ASSETS OF AVERA ST. ANTHONY'S HOSPITAL FOUNDATION. THE AVERA ST. ANTHONY'S HOSPITAL FOUNDATION INCLUDES ENDOWMENT FUNDS WHICH HAVE BEEN ESTABLISHED FOR A VARIETY OF PURPOSES. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS (IF ANY), ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE HOSPITAL IS ORGANIZED AS A NEBRASKA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE AND ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED.
PART XI, LINE 2D - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS INCLUDED IN REVENUE ON FINANCIAL STATEMENTS -562,984. LOSS ON RETIREMENT OF LOAN -273,000.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS INCLUDED IN FUND BALANCE ON FINANCIAL STATEMENTS 351,450.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS INCLUDED IN REVENUE ON FINANCIAL STATEMENTS 562,984.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served1946PersonsServed
Total Community Benefit Expense585000TotalCommunityBenefitExpense
Net Community Benefit Expense585000NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served4769PersonsServed
Total Community Benefit Expense2411490TotalCommunityBenefitExpense
Direct Offsetting Revenue2096884DirectOffsettingRevenue
Net Community Benefit Expense314606NetCommunityBenefitExpense
Percent Of Total Expense0.00930PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served6715PersonsServed
Total Community Benefit Expense2996490TotalCommunityBenefitExpense
Direct Offsetting Revenue2096884DirectOffsettingRevenue
Net Community Benefit Expense899606NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served3039PersonsServed
Total Community Benefit Expense216188TotalCommunityBenefitExpense
Direct Offsetting Revenue73525DirectOffsettingRevenue
Net Community Benefit Expense142663NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense200761TotalCommunityBenefitExpense
Net Community Benefit Expense200761NetCommunityBenefitExpense
Percent Of Total Expense0.00590PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Benefit Expense199763TotalCommunityBenefitExpense
Net Community Benefit Expense199763NetCommunityBenefitExpense
Percent Of Total Expense0.00590PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense852TotalCommunityBenefitExpense
Net Community Benefit Expense852NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served3039PersonsServed
Total Community Benefit Expense617564TotalCommunityBenefitExpense
Direct Offsetting Revenue73525DirectOffsettingRevenue
Net Community Benefit Expense544039NetCommunityBenefitExpense
Percent Of Total Expense0.01600PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served9754PersonsServed
Total Community Benefit Expense3614054TotalCommunityBenefitExpense
Direct Offsetting Revenue2170409DirectOffsettingRevenue
Net Community Benefit Expense1443645NetCommunityBenefitExpense
Percent Of Total Expense0.04260PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served9329PersonsServed
Total Community Building Expense119960TotalCommunityBuildingExpense
Direct Offsetting Revenue72173DirectOffsettingRevenue
Net Community Building Expense47787NetCommunityBuildingExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense109048TotalCommunityBuildingExpense
Net Community Building Expense109048NetCommunityBuildingExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served9329PersonsServed
Total Community Building Expense229008TotalCommunityBuildingExpense
Direct Offsetting Revenue72173DirectOffsettingRevenue
Net Community Building Expense156835NetCommunityBuildingExpense
Percent Of Total Expense0.00460PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$562,984BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare16664903AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare16977546CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-312643MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1AVERA ST ANTHONY'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1300 N 2ND STREETAddressLine1
CityONEILLCity
StateNEState
ZIP Code68763ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherPROVIDER BASED CLINICS - 1 RHC & 4 PHYSICIAN CLINICSOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST ANTHONY'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 3C: TO DETERMINE ELIGIBILITY FOR CHARITY CARE, AVERA ST. ANTHONY'S HOSPITAL HAS DEVELOPED A TEST WHICH UTILIZES A COMBINATION OF HOUSEHOLD INCOME, HOUSEHOLD ASSETS, AND ALSO CONSIDERS UNPAID PAST AND ONGOING MEDICAL EXPENSES. CHARITY DISCOUNT MAY RANGE FROM 10 - 100% DEPENDING ON SCORE.
PART I, LINE 6A: WE HAVE A COMMUNITY BENEFIT REPORT SPECIFIC TO OUR HOSPITAL AVAILABLE ON OUR WEBSITE OR ON REQUEST AS WELL AS 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 WAS CONVERTED TO COST BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID AND SUBSIDIZED HEALTH SERVICES WERE CONVERTED TO COST USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. OTHER BENEFITS ARE ACTUAL EXPENSES RECORDED IN THE GENERAL LEDGER.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR OF THE CALCULATION WAS $562,984.
PART II: LIFELINE IS A SECURE PERSONAL MEDICAL ALERT EMERGENCY RESPONSE SERVICE FOR THE ELDERLY AND DISABLED. THIS SERVICE ASSISTS THESE INDIVIDUALS TO LIVE WITH GREATER INDEPENDENCE BY LIVING ALONE BUT STILL HAVING ACCESS TO MEDICAL HELP. VAN TRANSPORTATION IS PROVIDED TO INDIVIDUALS THAT ARE UNABLE TO DRIVE. WITH NO PUBLIC TRANSPORTATION IN OUR AREA THE VAN TRANSPORTATION HELPS BUS CHILDREN TO SCHOOL AND TAKES THE ELDERLY SHOPPING AND TO HEALTH CARE APPOINTMENTS. THE VAN EVEN OFFERS TRANSPORTATION TO LARGER CITIES ABOUT 200 MILES AWAY WITH ADVANCE NOTICE FOR SPECIALTY MEDICAL SERVICES.
PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION. THE ORGANIZATION DID NOT ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY AS THE ORGANIZATION WORKS HARD AT ENCOURAGING PEOPLE TO APPLY AND MAKES ADJUSTMENTS TO BAD DEBT EXPENSE BASED ON RECOMMENDATIONS OF THE COLLECTION AGENCY OR REVIEWS BAD DEBT FOR THOSE WHO QUALIFY UNDER CHARITY CARE. BAD DEBT EXPENSE IS REPORTED NET OF DISCOUNTS AND CONTRACTUAL ALLOWANCES. A PAYMENT ON AN ACCOUNT PREVIOUSLY WRITTEN OFF REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR.THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 5 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 CMS. ST. ANTHONY'S FOLLOWS THE CHA GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL 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 A REASONABLE TIME PERIOD, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INDICATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. AT SUCH TIME AS THE ORGANIZATION SENDS THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY SHALL REFLECT THE REDUCED-PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. AVERA ST. ANTHONY'S HOSPITAL DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES AVERA ST. ANTHONY'S HOSPITAL UTILIZES MAY REPORT TO THE CREDIT AGENCIES. ANY EXTENDED PAYMENT PLANS OFFERED BY THE HOSPITAL, OR THE HOSPITAL'S REPRESENTATIVE, IN SETTLING THE OUTSTANDING BILLS OF PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
PART V, SECTION B, LINE 3: OUR HOSPITAL WORKED WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT AND 10 OTHER HOSPITALS IN THE HEALTH DEPARTMENT'S DISTRICT. THIS COLLABORATIVE APPROACH ALLOWED FOR ADDITIONAL RESOURCES AND THE SUPPORT AND EXPERTISE OF A STATE PUBLIC HEALTH AGENCY.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 4: CNCS, OSMOND GENERAL HOSPITALANTELOPE MEMORIAL HOSPITALBROWN COUNTY HOSPITALNIOBRARA VALLEY HOSPITALTILDEN COMMUNITY HOSPITALWEST HOLT MEMORIAL HOSPITALCHERRY COUNTY HOSPITALAVERA CREIGHTON HOSPITALOSMOND GENERAL HOSPITALROCK COUNTY HOSPITALST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 5C: THE CHNA IS AVAILABLE AT THE FOLLOWING LINK: HTTP://WWW.AVERA.ORG/EXPERIENCE/SHARED/COMMUNITY-NEEDS-HEALTH-ASSESSMENTS/.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 6I: THE ORGANIZATION'S IMPLEMENTATION STRATEGY MAY BE FOUND ON THEIR WEBSITE AT: HTTP://WWW.AVERA.ORG/EXPERIENCE/SHARED/COMMUNITY-NEEDS-HEALTH-ASSESSMENTS/.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 7: THE FOLLOWING NEEDS WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS NEEDS IN SURROUNDING AREAS, HOWEVER THEY WERE NOT IDENTIFIED IN THE PRIMARY MARKET AREA OF THE HOSPITAL; THEREFORE, THEY WILL NOT BE ADDRESSED: WORKSITE WELLNESS INCENTIVES; VACCINATION AGAINST SEASONAL INFLUENZA AND PNEUMOCOCCAL DISEASE; ANNUAL DENTAL REFERRALS; YOUTH MENTAL HEALTH PROGRAMS ADDRESSING BULLYING, SUICIDE ATTEMPTS, AND DOMESTIC/DATING VIOLENCE AWARENESS AND PREVENTION; SKIN CANCER/SUN SAFETY; COLORECTAL CANCER SCREENING; AND FOOD BORNE ILLNESSES.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 14G: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS, WAITING ROOMS, AND ADMISSIONS OFFICE AND INCLUDED ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 18E: IF A PATIENT IS SELF PAY AND HAS A LARGE BALANCE A THIRD PARTY AGENCY, THE MIDLAND GROUP, IS USED TO HELP THEM APPLY FOR MEDICAID. IF THEY ARE NOT ELIGIBLE FOR MEDICAID A COMPLETED CHARITY APPLICATION IS PROCESSED.ST. ANTHONY'S HOSPITAL
PART V, SECTION B, LINE 22: 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.ST. ANTHONY'S HOSPITAL
PART VI, LINE 2: AVERA ST. ANTHONY'S HOSPITAL CONDUCTS AN ANNUAL STRATEGIC PLANNING MEETING THAT INCLUDES A CROSS SECTION OF COMMUNITY MEMBERS. OUR HOSPITAL BOARD OF DIRECTORS, HOSPITAL FINANCE COMMITTEE, FOUNDATION BOARD OF DIRECTORS, COMMUNITY MEDICAL STAFF, AND HOSPITAL DEPARTMENT DIRECTORS MEET TO ASSESS COMMUNITY INPUT FROM THE LOCAL NURSING FACILITY, ASSISTED LIVING, AND LOCAL PUBLIC HEALTH OFFICE. OUR HOSPITAL AND FOUNDATION BOARDS AND FINANCE COMMITTEE ARE MADE UP OF A MAJORITY OF COMMUNITY MEMBERS. THIS GROUP DRAFTS AN ANNUAL STRATEGIC PLAN OF GOALS, OBJECTIVES, AND STRATEGIES THAT ARE CONTINUOUSLY UPDATED TO ADDRESS THE NEEDS OF THE COMMUNITY. ADDITIONALLY, INPUT FROM THE LOCAL MINISTERIAL ASSOCIATION, LAW ENFORCEMENT, CHAMBER OF COMMERCE, ELEMENTARY AND SECONDARY PUBLIC AND PAROCHIAL SCHOOLS, AND THE LOCAL COMMUNITY COLLEGE ARE ASSESSED AND INCORPORATED INTO THE PLAN. WE ARE ALSO CURRENTLY WORKING WITH OUR LOCAL HEALTH DEPARTMENT TO ASSESS ADDITIONAL COMMUNITY NEEDS.
PART VI, LINE 3: PATIENTS ARE INFORMED OF THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY THROUGH BROCHURES AND POSTED POLICIES AT THE REGISTRATION DESKS OF THE HOSPITAL AND EMERGENCY DEPARTMENT. AVERA ST. ANTHONY'S HAS STAFF IN CENTRAL REGISTRATION THAT IDENTIFY IF A PATIENT HAS THE FINANCIAL MEANS TO PAY FOR SERVICES OR INSURANCE TO COVER THESE SERVICES. PUBLIC ASSISTANCE IS ALSO PURSUED IF DEEMED APPROPRIATE. IF PATIENTS ARE IDENTIFIED AS CANDIDATES FOR CHARITY CARE THEY ARE DIRECTED TO OUR FINANCIAL SERVICES REPRESENTATIVE AND THE APPLICATION PROCESS IS INITITATED FOR CHARITY CARE. PATIENT FINANCIAL SERVICES CAN ASSIST WITH DETERMINING WHAT BENEFITS THE PATIENT MAY QUALIFY FOR AND ASSISTS WITH HELPING THEM APPLY FOR ANY BENEFITS. IF THERE IS NO OPTION FOR AN OUTSIDE ASSISTANCE PROGRAM, THE PATIENT IS INFORMED AND ENCOURAGED TO COMPLETE THE APPLICATION THAT UTILIZES A COMBINATION OF INCOME, ASSETS, AND EXPENSES TO DETERMINE WHAT PERCENTAGE OF CHARITY CARE THEY WOULD QUALIFY FOR.
PART VI, LINE 4: AVERA ST. ANTHONY'S HOSPITAL IS LOCATED IN O'NEILL, NEBRASKA, THE COUNTY SEAT OF HOLT COUNTY. WE SERVE A LARGE RADIUS TO INCLUDE PATIENTS FROM BROWN, ROCK, BOYD, KEYA PAHA, WHEELER, KNOX, GARFIELD, AND ANTELOPE COUNTIES. IN 2010, THE POPULATION FOR HOLT COUNTY WAS ESTIMATED TO BE 10,435. APPROXIMATELY 20.5% OF THE POPULATION IS AGE 65 OR OLDER. THE AVERAGE PER CAPITA INCOME IS $22,498 AND APPROXIMATELY 7.8% OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. THE NEAREST HOSPITAL IN THE AREA IS APPROXIMATELY 18 MILES FROM AVERA ST. ANTHONY.
PART VI, LINE 5: THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF VOLUNTEER MEMBERS WHO RESIDE IN THE COMMUNITY. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED IN FACILITIES TO IMPROVE PATIENT CARE. THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY.
PART VI, LINE 6: THE COMMUNITIES IN WHICH AVERA OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFIT NEEDS AND IN KEEPING WITH THE CATHOLIC HEALTHCARE ASSOCIATION GUIDELINES EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE CORPORATE STAFF OF AVERA HEALTH ADVOCATES FOR ALL MEMBERS REGARDING COMMUNITY BENEFIT RELATED MATTERS OF STATE, REGIONAL, AND NATIONAL IMPORTANCE.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1NORTHEAST COMMUNITY COLLEGE FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 E BENJAMIN AVE PO BOX 469AddressLine1
CityNORFOLKCity
StateNEState
ZIP Code687020469ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient510145185EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant20000AmountOfCashGrant
Purpose Of GrantHELP WITH EXPANSION OF O'NEILL, NEBRASKA CAMPUSPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION PROVIDED SUPPORT FOR A BUILDING PROJECT. THIS PROJECT WILL BE MONITORED TO COMPLETION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RONALD CORK
PRESIDENT & CEO0207751000504901037102500022567100
MICHAEL GARMAN
SEC/TREAS & SRVP FINANCE1403290001858058130188490166849000
EDWIN N COOK
RADIOLOGIST53210600080070106090233920574114000
MARK H MEYER
ORTHOPEDIC SURGEON4955860007118010555011700514429000
DEAN L BENSON
ORTHOPEDIC PA137162000270054870137750156694000
CAMERON EVERITT
DIRECTOR OF PT/OT161712000297065490162180184776000
ANTHONY AKAINDA
GENERAL SURGEON35336800018180103380204360385960000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSCHEDULE J, PART I, LINE 3: THE PRESIDENT & CEO'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, SACRED HEART HEALTH SERVICES. AVERA ST. ANTHONY'S HOSPITAL RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT & CEO USING THE METHODS DESCRIBED IN PART I, LINE 3.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE 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 7AAVERA 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 7BAVERA 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 8BAVERA ST. ANTHONY'S HOSPITAL DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE CEO AND CFO. AFTER INITIAL REVIEWS, A DRAFT IS PROVIDED TO THE FINANCE COMMITTEE FOR FINAL REVIEW. THE RETURN IS PROVIDED TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE 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.
COMPENSATION OF THE CEO IS DETERMINED BY AVERA SACRED HEART HOSPITAL, A RELATED EXEMPT ORGANIZATION. THE BOARD OF DIRECTORS REVIEWS THE MANAGEMENT AGREEMENT WITH AVERA SACRED HEART HOSPITAL AND DISCUSSES AND APPROVES THE AGREEMENT. NEGOTIATIONS ARE DONE AS NEEDED. FOR THE CFO, A SALARY REVIEW IS DONE BY A COMMITTEE BASED ON HOSPITAL ASSOCIATION SURVEYS, INCLUDING HOSPITAL SIZE. THERE IS ALSO A RELATIONSHIP BETWEEN THE CEO'S SALARY AND THE CFO'S SALARY, IN THAT A PERCENTAGE OF THE INCREASE FOR THE CFO IS BASED ON CEO'S SALARY BASE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11GREPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 978,606. MANAGEMENT AND GENERAL EXPENSES 107,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,086,099. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,016,124. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,016,124. MISCELLANEOUS FEES: PROGRAM SERVICE EXPENSES 2,331,384. MANAGEMENT AND GENERAL EXPENSES 108,337. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,439,721.OTHER FEES
FORM 990, PART XI, LINE 9:LOSS ON RETIREMENT OF LOAN -273,000.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA ST. ANTHONY'S HOSPITAL.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
AVERA HEALTH
3900 W AVERA DRIVE SUITE 300SIOUX FALLSSD57108460422673PROMOTION OF HEALTHSD501(C)(3)LINE 9N/A0
AVERA HOLY FAMILY
826 NORTH 8TH STREETESTHERVILLEIA51334420680370HEALTHCARE SERVICESIA501(C)(3)LINE 30AVERA HEALTH
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREETESTHERVILLEIA51334421317452SUPPORT OF HOLY FAMILY HOSPITAL AND HOME HEALTH AGENCYIA501(C)(3)LINE 90AVERA HOLY FAMILY
ST BENEDICT HEALTH CENTER
401 WEST GLYNN DRIVEPARKSTONSD57366460226738HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
ST BENEDICT HEALTH CENTER FOUNDATION
401 WEST GLYNN DRIVE PO BOX BPARKSTONSD57366460458725SUPPORT HEALTH RELATED SERVICESSD501(C)(3)LINE 11A, I0ST BENEDICT HEALTH CENTER
AVERA MCKENNAN
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117460224743HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
AVERA GETTYSBURG
606 EAST GARFIELDGETTYSBURGSD57442460234354HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA ST MARY'S
AVERA QUEEN OF PEACE HOSPITAL
525 NORTH FOSTERMITCHELLSD57301420224604HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
SACRED HEART HEALTH SERVICES
501 SUMMIT STREETYANKTONSD57078460225483HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
HEALTH MANAGEMENT SERVICES
501 SUMMIT STREETYANKTONSD57078460399291ADULT DAYCARE AND HOMEMAKING SERVICESSD501(C)(3)LINE 90SACRED HEART HEALTH SERVICES
LEWIS AND CLARK HEALTH ED AND SERV AGENCY
1000 W 4TH STREET SUITE 9YANKTONSD57078460337013HEALTHCARE EDUCATIONSD501(C)(3)LINE 90SACRED HEART HEALTH SERVICES
AVERA ST LUKE'S
305 SOUTH STATE STREETABERDEENSD57401460224598HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
AVERA MARSHALL
300 S BRUCE STMARSHALLMN56258410919153HEALTHCARE SERVICESMN501(C)(3)LINE 30AVERA HEALTH
AVERA MARSHALL FOUNDATION
300 S BRUCE STMARSHALLMN56258411784801FUNDRAISINGMN501(C)(3)LINE 90AVERA MARSHALL
AVERA ST MARY'S
801 EAST SIOUX AVENUEPIERRESD57501460230199HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
ST ANTHONY'S HOSPITAL FOUNDATION
300 NORTH 2ND STREETONEILLNE68763470728707SUPPORT TO AVERA ST. ANTHONY'S HOSPITALNE501(C)(3)LINE 11A, I1AVERA ST ANTHONY'S HOSPITAL

Form990 Schedule R Part III Form990ScheduleRPartIII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117460488198MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
MRIS LLC
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117470874983HEALTH CARE SERVICES INCLUDING AIRCRAFTSDN/A
HOME MEDICAL EQUIPMENT OF PIERRE LLC
329 E DAKOTAPIERRESD57501460444002MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF FLOYD VALLEY HOSPITAL LLC
714 E LINCOLN ST NELEMARSIA51031820582350MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC
PO BOX 5045SIOUX FALLSSD57117201686097MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC
38 19TH ST SWSIOUX CENTERIA51250753203100MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC
1104 EAST COLLEGE DRIVEMARSHALLMN56258205271924MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVENUE 102SIOUX FALLSSD57117800619999MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
Q&M PROPERTIES LLC
525 NORTH FOSTERMITCHELLSD57301730652049MEDICAL CLINIC BUILDINGSDN/A
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA STABERDEENSD57401460461429SURGICAL ASSOCIATESSDN/A
HEART HOSPITAL OF SOUTH DAKOTA LLC
10720 SIKES PLACE SUITE 300CHARLOTTENC28277562143771HEALTHCARE SERVICESNCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
ACCOUNTS MANAGEMENT INC
5132 S CLIFF AVENUE SUITE 101SIOUX FALLSSD57108460373021COLLECTION SERVICESSDN/AC0
AVERA HEALTH PLANS INC
3900 WEST AVERA DRIVE SUITE 101SIOUX FALLSSD57105460451539HEALTH FINANCING AND HEALTH PLAN ADMINSDN/AC0
AVERA PROPERTY INSURANCE INC
610 W 23RD STREETYANKTONSD57078460463155PROPERTY INSURANCESDN/AC0
VALLEY HEALTH SERVICES
501 SUMMIT STREETYANKTONSD57078460357149RENTAL REAL ESTATESDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org1SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg