AVERA MCKENNAN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: AVERA MCKENNAN (EIN 46-0224743)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-15
IRS object ID: 201311359349305626
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-15T13:18:05-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	450250958	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EIDE BAILLY LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	800 NICOLLET MALL STE 1300	AddressLine1
City	MINNEAPOLIS	City
State	MN	State
ZIP Code	554027033	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	460224743	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	AVERA MCKENNAN	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	AVER	NameControl
Phone	6053228000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE PO BOX 5045	AddressLine1
City	SIOUX FALLS	City
State	SD	State
ZIP Code	571175045	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DR DAVID KAPASKA	Name
Title	REGIONAL PRESIDENT	Title
Phone	6053228000	Phone
Date Signed	2013-05-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KIM HUNWARDSEN CPA	Name
PTIN	P00484560	PTIN
Phone	6122536500	Phone
Date Prepared	2013-05-13	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DR DAVID KAPASKA	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE PO BOX 5045	AddressLine1
City	SIOUX FALLS	City
State	SD	State
ZIP Code	571175045	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	720347059	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.AVERAMCKENNAN.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1911	YearFormation
State Legal Domicile	SD	StateLegalDomicile
Activity Or Mission Description	PROMOTION OF HEALTH	ActivityOrMissionDescription
Nbr Voting Members Governing Body	20	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	11	NbrIndependentVotingMembers
Total Nbr Employees	6573	TotalNbrEmployees
Total Nbr Volunteers	1187	TotalNbrVolunteers
Total Gross UBI	6961467	TotalGrossUBI
Net Unrelated Business Txbl Income	1722010	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	7931949	ContributionsGrantsPriorYear
Contributions Grants Current Year	2006604	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	662236185	ProgramServiceRevenuePriorYear
Program Service Revenue CY	710238566	ProgramServiceRevenueCY
Investment Income Prior Year	5052503	InvestmentIncomePriorYear
Investment Income Current Year	5478842	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1840244	OtherRevenuePriorYear
Other Revenue Current Year	1681944	OtherRevenueCurrentYear
Total Revenue Prior Year	677060881	TotalRevenuePriorYear
Total Revenue Current Year	719405956	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	4118418	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	3588944	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	338604378	SalariesEtcPriorYear
Salaries Etc Current Year	371268910	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	61855	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	67066	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	797434	TotalFundrsngExpCurrentYear
Other Expense Prior Year	285920426	OtherExpensePriorYear
Other Expenses Current Year	307380219	OtherExpensesCurrentYear
Total Expenses Prior Year	628705077	TotalExpensesPriorYear
Total Expenses Current Year	682305139	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	48355804	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	37100817	RevenuesLessExpensesCY
Total Assets BOY	762444106	TotalAssetsBOY
Total Assets EOY	800980977	TotalAssetsEOY
Total Liabilities BOY	336399684	TotalLiabilitiesBOY
Total Liabilities EOY	348719013	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	426044422	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	452261964	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	AVERA MCKENNAN, AS PART OF AVERA, IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES.	MissionDescription
Significant New Program Services	1	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	325133306	Expense
Grants	3516681	Grants
Revenue	462472584	Revenue
Description	AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTERAVERA MCKENNAN PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF CHARITABLE HEALTH CARE SERVICES. AVERA MCKENNAN OPERATES UNDER THE TENETS OF THE ROMAN CATHOLIC CHURCH AND IN ACCORDANCE WITH THE PHILOSOPHY AND VALUES ESTABLISHED FOR AVERA HEALTH, A SPONSORED MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	39060730	Expense
Grants	35761	Grants
Revenue	47714386	Revenue
Description	RURAL CRITICAL ACCESS HOSPITALSAVERA MCKENNAN OWNS OR LEASES RURAL CRITICAL ACCESS HOSPITALS IN FLANDREAU, GREGORY, DELL RAPIDS, MILBANK AND MILLER (HAND COUNTY), SD. AS SUCH, THEY OPERATE AS A DEPARTMENT OF AVERA MCKENNAN. THE HOSPITALS IN FLANDREAU, GREGORY AND HAND COUNTY SERVE MEDICALLY UNDERSERVED COUNTIES. IN ADDITION TO THE FOLLOWING EXEMPT PURPOSE ACHIEVEMENTS, RURAL HOSPITALS PARTICIPATE IN MANY OF THE ABOVE AS PART OF AVERA MCKENNAN.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	184116649	Expense
Grants	35750	Grants
Revenue	154012920	Revenue
Description	CLINICSAVERA MCKENNAN PROVIDES CLINICAL CARE, SECONDARY AND PRIMARY, IN 87 OWNED/JOINT VENTURE CLINICS IN SOUTH DAKOTA, NORTHWEST IOWA, SOUTHWEST MINNESOTA AND NORTHEASTERN NEBRASKA. IN ADDITION TO THE FOLLOWING EXEMPT PURPOSE ACHIEVEMENTS, CLINICS PARTICIPATE IN MANY OF THE ABOVE AS PART OF AVERA MCKENNAN. CLINIC VISITS IN 2012 TOTALED 1,022,290.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	30541087	Expense
Grants	750	Grants
Revenue	46929942	Revenue
Description	AVERA MCKENNAN ALSO PROVIDES LONG-TERM CARE, HOME MEDICAL EQUIPMENT & OTHER RETAIL, HOME INFUSION, RESEARCH, FITNESS CENTER, REGIONAL LAB, AND MOBILE SERVICES.MEDICAL RESEARCH: AS A RESEARCH INSTITUTION, AVERA MCKENNAN DRAWS PHYSICIANS WHO ARE COMMITTED TO SEEKING NEW TREATMENTS AND PREVENTIVE MEASURES. THE AVERA RESEARCH INSTITUTE IS CURRENTLY CONDUCTING PRE-CLINICAL RESEARCH TO ADD TO THE BODY OF MEDICAL KNOWLEDGE IN THE AREAS OF KIDNEY DISEASE LINKED TO OBESITY, KIDNEY FILTRATION AND GROWTH, AND NEUROSCIENCE RESEARCH IN REGARD TO STRESS AND ADDICTION. THE AVERA RESEARCH INSTITUTE ALSO CONTINUES ONGOING APPLIED RESEARCH IN THE AREA OF DEVELOPING A NOVEL PHOTOCHEMICAL TISSUE BONDING TECHNOLOGY THAT HAS OPHTHALMOLOGIC AND DERMATOLOGICAL APPLICATIONS. THROUGH ITS GENETICS LAB, AVERA MCKENNAN IS STUDYING GENETIC PRECURSORS OF MENTAL HEALTH CONDITIONS, WHICH HAS WIDE APPLICATION IN BOTH THE CLINICAL AND RESEARCH ARENAS. THE AVERA RESEARCH INSTITUTE IN 2012 PARTICIPATED IN 90 CLINICAL TRIALS, INVOLVING CANCER, ALZHEIMER'S DISEASE, HYPERCHOLESTEROLEMIA, RHEUMATOID ARTHRITIS, AND MORE. IN FISCAL YEAR 2012, AVERA MCKENNAN OPERATED THE AVERA RESEARCH INSTITUTE AT A LOSS OF $3,625,000.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	30541087	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	750	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	46929942	TotalOfOtherProgramServiceRev
Total Program Service Expense	578851772	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	1	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	1	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	408	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	6573	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	20	NbrVotingGoverningBodyMembers
Number Independent Voting Members	11	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	0	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JULIE NORTON	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6053228000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE	AddressLine1
City	SIOUX FALLS	City
State	SD	State
ZIP Code	571175045	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
TOM DEMPSTER
CHAIRMAN	2.00	X	X	0	0	0
DAVE ROZENBOOM
VICE CHAIR	2.00	X	X	0	0	0
DAVE KAPASKA DO
PRESIDENT & CEO	40.00	X	X	0	656504	42862
MICHAEL BENDER
BOARD TRUSTEE	2.00	X		0	0	0
SISTER JANICE KLEIN
BOARD TRUSTEE	2.00	X		0	0	0
GENE JONES JR
BOARD TRUSTEE	2.00	X		0	0	0
MITCHELL JOHNSON DO
BOARD TRUSTEE	2.00	X		0	0	0
SISTER KATHRYN EASLEY
BOARD TRUSTEE	2.00	X		0	0	0
KIM PEDERSON MD
BOARD TRUSTEE	40.00	X		297192	0	32850
SISTER JOAN REICHELT
BOARD TRUSTEE	2.00	X		0	0	0
BRAD THAEMERT MD
BOARD TRUSTEE	2.00	X		0	0	0
FRED THURMAN
BOARD TRUSTEE	2.00	X		0	0	0
DAVID FLECK
BOARD TRUSTEE	2.00	X		0	0	0
JAMES WIEDERRICH
BOARD TRUSTEE	2.00	X		0	0	0
BILL ROSSING MD
BOARD TRUSTEE	2.00	X		0	0	0
CINDY WALSH
BOARD TRUSTEE	2.00	X		0	0	0
DAVID CHICOINE
BOARD TRUSTEE	2.00	X		0	0	0
SISTER CANDYCE CHRYSTAL
BOARD TRUSTEE	2.00	X		0	0	0
HUGH VENRICK
BOARD TRUSTEE	2.00	X		0	0	0
DON KOSIAK MD
BOARD TRUSTEE	40.00	X		415820	0	23049
JULIE N NORTON
SEC/TREAS & SRVP FINANCE	40.00		X	352422	0	40472
JUDY BLAUWET
SR VICE PRESIDENT	40.00			321080	0	31522	X
DAVID FLICEK
SR VICE PRESIDENT	40.00			0	481676	33447	X
STEVE PETERSEN
DIRECTOR-PHARMACY	40.00			192830	0	30409	X
PATRICIA JAGOE
AVP-SURGERY	40.00			189955	0	33907	X
CURT HOHMAN
SR VICE PRESIDENT	40.00			270592	0	24125	X
HAMID ABBASI MD
PHYSICIAN	40.00			1116926	0	34882		X
BRIAN KNUTSON MD
PHYSICIAN	40.00			1126170	0	37382		X
DANIEL TYNAN MD
PHYSICIAN	40.00			1235370	0	35882		X
STEVEN CONDRON MD
PHYSICIAN	40.00			1221312	0	39882		X
KELLY MCCAUL MD
PHYSICIAN	40.00			1061761	0	24625		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	7801430	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1138180	TotalReportableCompFrmRltdOrgs
Total Other Compensation	465296	TotalOtherCompensation
Number Individuals GT100 K	483	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
AVERA CENTRAL SERVICES
3900 WEST AVERA DRIVE	SIOUX FALLS	SD	57108	SHARED SERVICES	21532100
SIOUX FALLS CONSTRUCTION
PO BOX 2728	SIOUX FALLS	SD	571072728	CONSTRUCTION	5033131
SANFORD SCHOOL OF MEDICINE
1400 W 22ND ST 120	SIOUX FALLS	SD	571051505	PHYSICIAN SERVICES	2821907
MEDICAL X-RAY CENTER
1417 S MINNESOTA AVE	SIOUX FALLS	SD	57105	RADIOLOGY SERVICES	1870931
ASSOCIATED REGIONAL & UNIVERSITY PATHOLO
PO BOX 27964	SALT LAKE CITY	UT	84127	LAB TESTING	1841330

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	74	NumberOfContractorsGT100K
Federated Campaigns	45986	FederatedCampaigns
Related Organizations	1107700	RelatedOrganizations
Government Grants	148815	GovernmentGrants
All Other Contributions	704103	AllOtherContributions
Noncash Contributions	73149	NoncashContributions
Total Contributions	2006604	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE RE	622110	653105834	653105834
OTHER PATIENT AND CLIN	621500	39265416	33222003	6043413
INCOME FROM SUBSIDIARI	423000	10660617	10478345	182272
PROGRAM RENT	900099	1471715	1471715
INTEREST IN FOUNDATION	900099	595687	595687

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	5139297	TotalRevenueColumn
Related Or Exempt Function Income	5119832	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	19465	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	710238566	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	130715	TotalRevenueColumn
Exclusion	$130,715	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1015464	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	941103	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	74361	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	74361	TotalRevenueColumn
Exclusion	$74,361	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	5319453	Securities
Other	28674	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	5319453	Securities
Other	28674	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	5348127	TotalRevenueColumn
Exclusion	$5,348,127	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
INTEREST INCOME	900099	891266	891266
COMMERCIAL TESTING	621500	698071		698071
MANAGEMENT SERVICES	541610	18246		18246

Field	Value	IRS element (for citing)
Total Other Revenue	1607583	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	719405956	TotalRevenueColumn
Related Or Exempt Function Income	704884682	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	6961467	UnrelatedBusinessRevenue
Exclusion	$5,553,203	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	3463944	Total
Program Services	3463944	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	125000	Total
Program Services	125000	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2319959	Total
Program Services	1019669	ProgramServices
Management And General	1300290	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	296903173	Total
Program Services	271997589	ProgramServices
Management And General	24533061	ManagementAndGeneral
Fundraising	372523	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	16668374	Total
Program Services	14864366	ProgramServices
Management And General	1779528	ManagementAndGeneral
Fundraising	24480	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	36532443	Total
Program Services	32387878	ProgramServices
Management And General	4088632	ManagementAndGeneral
Fundraising	55933	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	18844961	Total
Program Services	16770516	ProgramServices
Management And General	2047908	ManagementAndGeneral
Fundraising	26537	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	167179	Total
Program Services	167179	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	641500	Total
Program Services	309170	ProgramServices
Management And General	332330	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	66946	Total
Program Services	13871	ProgramServices
Management And General	53075	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	35343	Total
Management And General	35343	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	67066	Total
Fundraising	67066	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	88765546	Total
Program Services	53011896	ProgramServices
Management And General	35748783	ManagementAndGeneral
Fundraising	4867	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3617795	Total
Program Services	414944	ProgramServices
Management And General	3184864	ManagementAndGeneral
Fundraising	17987	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	9879677	Total
Program Services	5110756	ProgramServices
Management And General	4582101	ManagementAndGeneral
Fundraising	186820	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	7747684	Total
Program Services	850843	ProgramServices
Management And General	6896841	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	20090967	Total
Program Services	13921575	ProgramServices
Management And General	6144890	ManagementAndGeneral
Fundraising	24502	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	3279993	Total
Program Services	2635776	ProgramServices
Management And General	638187	ManagementAndGeneral
Fundraising	6030	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1982068	Total
Program Services	1737865	ProgramServices
Management And General	243572	ManagementAndGeneral
Fundraising	631	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	8103423	Total
Program Services	7862250	ProgramServices
Management And General	241173	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	34620097	Total
Program Services	28252771	ProgramServices
Management And General	6362271	ManagementAndGeneral
Fundraising	5055	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1064988	Total
Program Services	1055402	ProgramServices
Management And General	9586	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES	100661292	100237100	422657	1535
BAD DEBT EXPENSE	18283341	18283341
EQUIPMENT LEASE AND REN	3766383	2901311	865072
UBI TAX	431759	431759

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4174238	Total
Program Services	1025001	ProgramServices
Management And General	3145769	ManagementAndGeneral
Fundraising	3468	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	682305139	Total
Program Services	578851772	ProgramServices
Management And General	102655933	ManagementAndGeneral
Fundraising	797434	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	26868405	BOY
EOY	28110750	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	3360173	BOY
EOY	2439599	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	85293914	BOY
EOY	92528140	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	120833	BOY
EOY	20833	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	3431202	BOY
EOY	3360181	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	12517902	BOY
EOY	14389349	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5340257	BOY
EOY	8098767	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	661320856	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	317713194	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	335141000	BOY
EOY	343607662	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	23658088	BOY
EOY	8322781	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	202453890	BOY
EOY	207116305	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	6876999	BOY
EOY	12187088	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	42209593	BOY
EOY	44273450	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	15171850	BOY
EOY	36526072	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	762444106	BOY
EOY	800980977	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	66443712	BOY
EOY	65431052	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	519843	BOY
EOY	791440	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	211970759	BOY
EOY	224989669	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	803045	BOY
EOY	818999	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	26333662	BOY
EOY	22024359	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	30328663	BOY
EOY	34663494	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	336399684	BOY
EOY	348719013	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	414988501	BOY
EOY	440185934	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	9034012	BOY
EOY	9934388	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2021909	BOY
EOY	2141642	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	426044422	BOY
EOY	452261964	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	762444106	BOY
EOY	800980977	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	37100817	ReconcilationRevenueExpenses
Reconcilation Other Changes	-10883275	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	1	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$33,620	GrantsOtherOrganizationsAmount
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$1,723	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	35343	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	PART II-B LINE 1F AND 1G: AVERA MCKENNAN PARTICIPATES THROUGH VARIOUS HOSPITAL ORGANIZATIONS TO PROMOTE LEGISLATION THAT WOULD RESULT IN STRENGTHENING HEALTH CARE DELIVERY SYSTEMS ON A NATIONAL, REGIONAL, AND LOCAL LEVEL. AN EMPLOYEE OF MCKENNAN MET WITH CONGRESSIONAL MEMBERS TO DISCUSS AND PROMOTE THE 340B DRUG PROGRAM. ANOTHER EMPLOYEE OF MCKENNAN ALSO MET WITH CONGRESSIONAL MEMBERS TO DISCUSS DRUG SHORTAGES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	1	AgentTrusteeEtc
Beginning Balance	9654	BeginningBalance
Additions During Year	113736	AdditionsDuringYear
Distributions During Year	111545	DistributionsDuringYear
Ending Balance	11845	EndingBalance
Included On FS	1	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2021909	BeginningOfYearBalance
Investment Earnings Or Losses	119733	InvestmentEarningsOrLosses
End Of Year Balance	2141642	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1981042	BeginningOfYearBalance
Investment Earnings Or Losses	40867	InvestmentEarningsOrLosses
End Of Year Balance	2021909	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1897334	BeginningOfYearBalance
Investment Earnings Or Losses	83708	InvestmentEarningsOrLosses
End Of Year Balance	1981042	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2160515	BeginningOfYearBalance
Investment Earnings Or Losses	-263181	InvestmentEarningsOrLosses
End Of Year Balance	1897334	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	7249627	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	20252346	OtherCostOrOtherBasis
Book Value	27501973	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1245461	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	380803058	OtherCostOrOtherBasis
Depreciation	145624626	Depreciation
Book Value	236423893	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	236755633	OtherCostOrOtherBasis
Depreciation	166830135	Depreciation
Book Value	69925498	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	15014731	OtherCostOrOtherBasis
Depreciation	5258433	Depreciation
Book Value	9756298	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	343607662	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
ASSETS LIMITED AS TO USE - AVERA POOLED INVESTMENTS	174227695	F
AVERA HOME MEDICAL EQUIPMENT, LLC	4199216	C
HEART HOSPITAL OF SOUTH DAKOTA, LLC	12197248	C
INTEREST IN AVERA HEALTH FOUNDATION	11282031	F
INVESTMENTS IN AFFILIATED COMPANIES	5210115	C

Field	Value	IRS element (for citing)
Total Of Book Value Securities	207116305	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
OTHER LIABILITIES	$3,446,646
DUE TO OTHER ORGANIZATIONS	$1,174,897
MARKET VALUE OF INTEREST SWAP	$12,592,229
CAPITAL LEASE OBLIGATION	$24,459
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$12,003,995
DUE TO AFFILATE	$5,421,268

Field	Value	IRS element (for citing)
Total Of Amounts	34663494	TotalOfAmounts
Total Revenue	719405956	TotalRevenue
Total Expenses	682305139	TotalExpenses
Excess Or Deficit For Year	37100817	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-6031404	NetUnrealizedGLOnInvestments
Other	-$4,851,871	OtherAmount
Total Adjustments	-10883275	TotalAdjustments
Excess Or Deficit Per FS	26217542	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	752038879	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-6031404	NetUnrealizedGainsInvestments
Other Revenues	50963178	OtherRevenues
Revenue Not Rptd F990	44931774	RevenueNotRptdF990
Revenue Subtotal	707107105	RevenueSubtotal
Other Revenues Not Included	12298851	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	12298851	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	719405956	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	723014035	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	60767086	OtherExpensesIncluded
Expenses Not Rptd F990	60767086	ExpensesNotRptdF990
Expenses Subtotal	662246949	ExpensesSubtotal
Other Expenses Not Included	20058190	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	20058190	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	682305139	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (9 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART IV, LINE 1B:	THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS LONG-TERM CARE RESIDENTS. MANY SMALL DOLLAR TRANSACTIONS FLOW IN AND OUT OF THIS ACCOUNT. THE ACCOUNT IS MANAGED BY THE NURSING HOME STAFF. THE STATE HAS STRICT GUIDELINES ON HOW THESE ACCOUNTS ARE MANAGED.
PART IV, LINE 2B:	THE ORGANIZATION HOLDS AN AMOUNT IN TRUST RELATED TO A NON-COMPETE AS PART OF AN EMPLOYMENT AGREEMENT FOR AN EMPLOYED PHYSICIAN. THE AMOUNT WILL BE HELD AND THEN PAID OUT WHEN THE PHYSICIAN REACHES AGE 65 OR EARLIER ACCORDING TO THE WRITTEN TRUST AGREEMENT.
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT CONSISTS OF A PORTION OF THEIR INTEREST IN THE NET ASSETS OF AVERA HEALTH FOUNDATION. THE AVERA HEALTH FOUNDATION INCLUDES ENDOWMENT FUNDS WHICH HAVE BEEN ESTABLISHED FOR A VARIETY OF PURPOSES. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS (IF ANY), ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ORGANIZATION'S PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE DONOR RESTRICTED. THE ORGANIZATION CURRENTLY DOES NOT HAVE ANY BOARD DESIGNATED ENDOWMENT FUNDS.	DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X:	THE ORGANIZATION IS ORGANIZED AS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). CERTAIN CONSOLIDATED SUBSIDIARIES, INCLUDING AVERA HOME MEDICAL EQUIPMENT LLC, MIDWEST REGIONAL IMAGING SERVICES LLC, HEART HOSPITAL OF SOUTH DAKOTA LLC, AND ALUMEND LLC, ARE NOT TAX EXEMPT ENTITIES AND ARE CONSIDERED PARTNERSHIPS OR DISREGARDED ENTITIES FOR TAX PURPOSES. AVERA MCKENNAN IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, AVERA MCKENNAN IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. AVERA MCKENNAN FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, CASH PAID FOR INCOME TAXES WAS $270,406 AND $112,143, RESPECTIVELY. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE ORGANIZATION'S FEDERAL FORM 990-T AND OTHER TAX RETURN FILINGS ARE GENERALLY NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
	EQUITY TRANSFERS, NET 755,783. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -5,258,882. LOSS ON RETIREMENT OF DEBT -1,419,188. OTHER CHANGES IN NET ASSETS 66,412. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP DESIGNATED AS HEDGE -883,328. GAIN ON ACQUISITION 2,724,749. BOOK TAX DIFFERENCE - EQUITY METHOD -15,814. BOOK TAX DIFFERENCE - CONSOLIDATED -821,603. TOTAL TO SCHEDULE D, PART XI, LINE 8: -4,851,871.	PART XI, LINE 8 - OTHER ADJUSTMENTS:
	REVENUES OF CONSOLIDATED SUBSIDIARIES CONSOLIDATED FOR FINANCIAL STATEMENTS 75,355,429. OCCUPANCY EXPENSES INCLUDED IN NONOPERATING INCOME ON FINANCIAL STATEMENTS -1,774,849. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP RECORDED IN N/A FOR TAX RETURN -5,258,882. RECLASS OF LOSSES ON INTEREST RATE SWAPS RECORDED IN N/A FOR TAX RETURN -380,740. LOSS FROM RETIREMENT OF DEBT RECORDED IN NET ASSETS FOR TAX RETURN -1,419,188. GAIN ON ACQUISITION 2,724,749. BAD DEBT EXPENSE REPORTED IN REVENUE FOR FINANCIAL STATEMENTS -18,283,341.	PART XII, LINE 2D - OTHER ADJUSTMENTS:
	CHANGE IN INVESTMENT IN AVERA HEALTH FDTN RECORDED IN FUND BALANCE ON F/S 101,688. GAIN FROM INVESTMENT IN SUBSIDIARIES RECORDED IN REVENUE FOR TAX RETURN 9,713,826. MANAGEMENT FEES INCLUDED IN EXPENSES ON FINANCIAL STATEMENTS 1,304,094. RENTAL EXPENSE INCLUDED IN REVENUES ON FINANCIAL STATEMENTS -941,103. BOOK TAX DIFFERENCES - CONSOLIDATED 821,603. CONTRIBUTION OF LONG-LIVED ASSET RECORDED IN NET ASSETS FOR FINANCIAL STMT 137,632. TEMP & PERM CHANGES 1,020,109. BOOK TAX DIFFERENCES - EQUITY METHOD 15,814. CHANGE IN NONCONTROLLING INTEREST IN HEART HOSPITAL OF SOUTH DAKOTA 125,188.	PART XII, LINE 4B - OTHER ADJUSTMENTS:
	EXPENSES OF CONSOLIDATED SUBSIDIARIES CONSOLIDATED FOR FINANCIAL STATEMENTS 61,130,077. MANAGEMENT FEES INCLUDED IN REVENUE FOR TAX RETURN -1,304,094. RENTAL EXPENSE INCLUDED IN EXPENSES FOR TAX RETURN 941,103.	PART XIII, LINE 2D - OTHER ADJUSTMENTS:
	OCCUPANCY EXPENSES INCLUDED IN THE NONOPERATING INCOME FOR THE F/S 1,774,849. BAD DEBT EXPENSE REPORTED IN REVENUE FOR FINANCIAL STATEMENTS 18,283,341.	PART XIII, LINE 4B - OTHER ADJUSTMENTS:

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Phone Solicitations	X	PhoneSolicitations
In Person Solicitations	X	InPersonSolicitations
Solicitation Of Non Govt Grants	X	SolicitationOfNonGovtGrants
Solicitation Of Govt Grants	X	SolicitationOfGovtGrants
Agreement Ref Fundraising	1	AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

Field	Value	IRS element (for citing)
Business Name Line1	RENAISSANCE GROUP INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	7701 DOUGLAS AVENUE	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	50322	ZIPCode

Field	Value	IRS element (for citing)
Activity	COUNSEL FOR FUNDRAISING CAMPAIGN SERVICES	Activity
Fundraiser Control Of Funds	0	FundraiserControlOfFunds
Gross Receipts	0	GrossReceipts
Amount Retained By Contractor	67066	AmountRetainedByContractor
Net To Organization	-67066	NetToOrganization

Field	Value	IRS element (for citing)
Total Retained By Contractors	67066	TotalRetainedByContractors
Total Net To Organization	-67066	TotalNetToOrganization

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent150	X	Pcent150
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10414956	TotalCommunityBenefitExpense
Net Community Benefit Expense	10414956	NetCommunityBenefitExpense
Percent Of Total Expense	0.01530	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	65128812	TotalCommunityBenefitExpense
Direct Offsetting Revenue	47217235	DirectOffsettingRevenue
Net Community Benefit Expense	17911577	NetCommunityBenefitExpense
Percent Of Total Expense	0.02630	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1163145	TotalCommunityBenefitExpense
Direct Offsetting Revenue	666176	DirectOffsettingRevenue
Net Community Benefit Expense	496969	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	76706913	TotalCommunityBenefitExpense
Direct Offsetting Revenue	47883411	DirectOffsettingRevenue
Net Community Benefit Expense	28823502	NetCommunityBenefitExpense
Percent Of Total Expense	0.04230	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3013948	TotalCommunityBenefitExpense
Direct Offsetting Revenue	298779	DirectOffsettingRevenue
Net Community Benefit Expense	2715169	NetCommunityBenefitExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6862988	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1576515	DirectOffsettingRevenue
Net Community Benefit Expense	5286473	NetCommunityBenefitExpense
Percent Of Total Expense	0.00770	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	50528552	TotalCommunityBenefitExpense
Direct Offsetting Revenue	43510527	DirectOffsettingRevenue
Net Community Benefit Expense	7018025	NetCommunityBenefitExpense
Percent Of Total Expense	0.01030	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3928027	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2728	DirectOffsettingRevenue
Net Community Benefit Expense	3925299	NetCommunityBenefitExpense
Percent Of Total Expense	0.00580	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1883011	TotalCommunityBenefitExpense
Net Community Benefit Expense	1883011	NetCommunityBenefitExpense
Percent Of Total Expense	0.00280	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	66216526	TotalCommunityBenefitExpense
Direct Offsetting Revenue	45388549	DirectOffsettingRevenue
Net Community Benefit Expense	20827977	NetCommunityBenefitExpense
Percent Of Total Expense	0.03060	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	142923439	TotalCommunityBenefitExpense
Direct Offsetting Revenue	93271960	DirectOffsettingRevenue
Net Community Benefit Expense	49651479	NetCommunityBenefitExpense
Percent Of Total Expense	0.07290	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	107846	TotalCommunityBuildingExpense
Net Community Building Expense	107846	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	15000	TotalCommunityBuildingExpense
Net Community Building Expense	15000	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	258086	TotalCommunityBuildingExpense
Net Community Building Expense	258086	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	380932	TotalCommunityBuildingExpense
Net Community Building Expense	380932	NetCommunityBuildingExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$18,283,341	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	142661645	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	123224808	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	19436837	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	7	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (7 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Childrens HospitalChildrensHospital	Teaching HospitalTeachingHospital	Research FacilityResearchFacility	Er24 HoursEr24Hours	OtherOther	Critical Access HospitalCriticalAccessHospital
AVERA MCKENNAN
1	1325 S CLIFF AVE	SIOUX FALLS	SD	57117	X	X	X	X	X	X	30 PROVIDER BASED CLINICS
HEART HOSPITAL OF SOUTH DAKOTA LLC
2	10720 SIKES PLACE SUITE 300	CHARLOTTE	NC	28277	X	X				X	2/3 OWNER IN JOINT VENTURE
AVERA GREGORY HEALTHCARE CENTER
3	400 PARK AVE	GREGORY	SD	57533	X	X				X	FOUR PROVIDER BASED CLINICS	X
AVERA MILBANK AREA HOSPITAL
4	901 VIRGIL AVE	MILBANK	SD	57252	X	X				X	THREE RURAL HEALTH PROVIDER BASED CLINICS	X
AVERA DELLS AREA HEALTH CENTER
5	909 N IOWA AVENUE	DELL RAPIDS	SD	57022	X	X				X	THREE PROVIDER BASED CLINICS	X
AVERA FLANDREAU MEDICAL CENTER
6	214 N PRAIRIE	FLANDREAU	SD	57028	X	X				X	ONE PROVIDER BASED CLINIC	X
AVERA HAND COUNTY MEMORIAL HOSPITAL
7	300 W 5TH ST	MILLER	SD	57362	X	X				X	ONE PROVIDER BASED CLINIC	X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (7 entries)

Hospital Facility NumberHospitalFacilityNumber	CHNA ConductedCHNAConducted	Eligibility Criteria ExplainedEligibilityCriteriaExplained	Uses FPG FreeUsesFPGFree	FPG Free PercentFPGFreePercent	Uses FPG DiscountedUsesFPGDiscounted	FPG Discount PercentFPGDiscountPercent	Explains BasisExplainsBasis	Income LevelIncomeLevel	Asset LevelAssetLevel	Medical IndigencyMedicalIndigency	Insurance StatusInsuranceStatus	Uninsured DiscountUninsuredDiscount	Medicaid MedicareMedicaidMedicare	State RegulationStateRegulation	Explains Application MethodExplainsApplicationMethod	Includes Publicity MeasuresIncludesPublicityMeasures	Posted On WebsitePostedOnWebsite	Available On RequestAvailableOnRequest	Other PublicityOtherPublicity	Actions On NonpaymentActionsOnNonpayment	Collection ActivitiesCollectionActivities	Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy	Used Other MethodUsedOtherMethod	Amounts Generally BilledAmountsGenerallyBilled	Gross ChargesGrossCharges
AVERA MCKENNAN
1	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
HEART HOSPITAL OF SOUTH DAKOTA LLC
2	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
AVERA GREGORY HEALTHCARE CENTER
3	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
AVERA MILBANK AREA HOSPITAL
4	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
AVERA DELLS AREA HEALTH CENTER
5	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
AVERA FLANDREAU MEDICAL CENTER
6	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1
AVERA HAND COUNTY MEMORIAL HOSPITAL
7	0	1	1	150.000000000000	1	400.000000000000	1	X	X	X	X	X	X	X	1	1	X	X	X	1	0	1	X	1	1

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	67	NumberOfOtherFacilities

Other Facilities OtherFacilities (67 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType	Address Line2Address/AddressLine2
AVERA MCKENNAN BEHAVIORAL HEALTH CTR
4400 W 69TH ST	SIOUX FALLS	SD	57108	INPATIENT & OUTPATIENT BEHAVIORAL HEALTH SERVICES
AVERA MEDICAL GROUP PIERRE
100 MAC LANE	PIERRE	SD	57501	PRIMARY AND SPECIALTY CLINIC; OUTPATIENT SURGERY CENTER
CORE ORTHOPEDICS AVERA MEDICAL GROUP
2908 EAST 26TH STREET	SIOUX FALLS	SD	57103	ORTHOPEDIC CLINIC
AVERA MEDICAL GROUP BROOKINGS
400 - 22ND AVENUE	BROOKINGS	SD	57006	PRIMARY CARE CLINIC
AVERA MCKENNAN HOME INFUSION
1020 S CLIFF AVENUE	SIOUX FALLS	SD	57105	COMPREHENSIVE HOME INFUSION THERAPIES & SUPPLIES
AVERA MEDICAL GROUP WORTHINGTON
508 TENTH STREET	WORTHINGTON	MN	56187	PRIMARY CARE CLINIC
AVERA PLAZA 2 PHARMACY
1301 S CLIFF AVENUE	SIOUX FALLS	SD	57105	RETAIL PHARMACY
AVERA MEDICAL GROUP SPENCER
116 EAST 11TH SUITE 101	SPENCER	IA	51301	PRIMARY CARE CLINIC
AVERA PRINCE OF PEACE
4500 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	SKILLED NURSING FACILITY
MCKENNAN REGIONAL LABORATORY
1325 S CLIFF AVENUE	SIOUX FALLS	SD	57105	LABORATORY SERVICES
AVERA HOME MEDICAL EQUIPMENT
2400 S MINNESOTA AVE	SIOUX FALLS	SD	57105	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
PET CT LLC
6001 SHARON AVENUE	SIOUX FALLS	SD	57108	MOBILE RADIOLOGY
AVERA MEDICAL GROUP MATERNAL FETAL
1417 SOUTH CLIFF AVENUE SUITE 100	SIOUX FALLS	SD	57105	HIGH-RISK PREGNANCY CARE CLINIC
AVERA MEDICAL GROUP PEDIATRIC SPEC
1417 S CLIFF AVENUE SUITE 010	SIOUX FALLS	SD	57105	PEDIATRIC SPECIALTIES CLINIC
AVERA MEDICAL GROUP SPIRIT LAKE MED
2700 - 23RD STREET SUITE A	SPIRIT LAKE	IA	51360	PRIMARY CARE CLINIC
AVERA MCKENNAN HOSP & UNIV HEALTH
CTR CAMPUS PHARMACY 1325 S CLIFF	SIOUX FALLS	SD	57105	RETAIL PHARMACY	AVE
AVERA MEDICAL GRP RADIATION ONCOLOGY
1000 EAST 23RD STREET SUITE 100	SIOUX FALLS	SD	57105	SPECIALTY CLINIC
AVERA MCKENNAN FITNESS CENTER
3400 S SOUTHEASTERN DRIVE	SIOUX FALLS	SD	57105	FITNESS CENTER
DOUGHERTY HOSPICE HOUSE
4509 PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	HOSPICE CARE
AVERA MEDICAL GROUP LAKES FAMILY PRACTIC
2700 - 23RD STREET SUITE C	SPIRIT LAKE	IA	51360	PRIMARY CARE CLINIC
AVERA ROSEBUD COUNTRY CARE CENTER
300 PARK AVENUE	GREGORY	SD	57533	SKILLED NURSING FACILITY
AVERA MEDICAL GROUP WINDOM
820 - 2ND AVENUE	WINDOM	MN	56101	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT
1104 EAST COLLEGE DR	MARSHALL	SD	56258	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQUIPMENT
418 S 2ND STREET	ABERDEEN	SD	57401	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA MEDICAL GROUP SIBLEY
600-9TH AVENUE NORTH	SIBLEY	IA	51249	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT
1001 W 9TH STREET	YANKTON	SD	57078	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
LAUREL OAKS APARTMENTS
4510 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	INDEPENDENT LIVING APARTMENTS
AVERA HOME MEDICAL EQUIPMENT
1307 N MAIN	MITCHELL	SD	57301	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA MEDICAL GROUP OCCUPATIONAL MEDICIN
4928 NORTH CLIFF AVENUE	SIOUX FALLS	SD	57104	BUSINESS AND CORPORATE HEALTH CARE CLINIC
AVERA MEDICAL GROUP RADIATION ONCOLOGY
1417 S MINNESOTA AVE	SIOUX FALLS	SD	57105	SPECIALTY CLINIC
AVERA HOME MEDICAL EQUIPMENT
1411 WELLS AVE	PIERRE	SD	57501	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA MEDICAL GROUP LIVER DISEASE
1315 SOUTH CLIFF AVENUE 1200	SIOUX FALLS	SD	57105	HEPATOLOGY CLINIC
AVERA HOME MEDICAL EQUIPMENT
1508 4TH STREET NE	WATERTOWN	SD	57201	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQUIPMENT
903 N WASHINGTON	MADISON	SD	57042	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA RESEARCH INSTITUTE
2020 S NORTON AVE	SIOUX FALLS	SD	57105	CLINICAL RESEARCH STUDIES
AVERA MEDICAL GROUP WOMEN'S MIDLIFE CARE
911 EAST 20TH STREET - SUITE 200	SIOUX FALLS	SD	57105	WOMEN'S SERVICES CLINIC
AVERA HOME MEDICAL EQUIPMENT
602 CENTRAL AVE	ESTHERVILLE	IA	51334	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQPT FLOYD VALLEY HSP
190 6TH AVE NE	LEMARS	IA	51031	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQUIPMENT
38 19TH STREET SW	SIOUX CENTER	IA	51250	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA MEDICAL GROUP COMP BREAST CARE
1000 EAST 23RD STREET - SUITE 200	SIOUX FALLS	SD	57018	SPECIALTY CLINIC
AVERA MEDICAL GROUP LARCHWOOD
916 HOLDER STREET PO BOX 8	LARCHWOOD	IA	51241	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT
1325 SOUTH CLIFF AVENUE	SIOUX FALLS	SD	57117	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQPT OF SPENCER
716 GRAND AVE	SPENCER	IA	51301	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQUIPMENT
102 WEST MAIN SUITE A	PARKSTON	SD	57366	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA DERMATOLOGY PHARMACY
6701 SOUTH MINNESOTA AVENUE	SIOUX FALLS	SD	57108	RETAIL PHARMACY
AVERA LEE MABEE OBGYN
1910 WEST 69TH SUITE 100	SIOUX FALLS	SD	57108	OBSTETRIC AND GYNECOLOGY CLINIC
AVERA MEDICAL GROUP MCGREEVY SALEM
740 SOUTH HILL	SALEM	SD	57058	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT
1565 DAKOTA AVE S	HURON	SD	57350	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA INSTITUTE FOR HUMAN GENETICS
4400 W 69TH ST SUITE 200	SIOUX FALLS	SD	57108	GENETIC RESEARCH PROGRAM
CURAQUICK AVERA CLINIC
3000 S MINNESOTA AVE	SIOUX FALLS	SD	57105	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP BIG STONE CITY
451 MAIN STREET	BIG STONE CITY	SD	57216	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP MCHALE INSTITUTE
3720 W 69TH STREET	SIOUX FALLS	SD	57108	CANCER CLINIC
HEGG MEDICAL CLINIC AVERA
2121 HEGG DRIVE	ROCK VALLEY	IA	51247	PRIMARY CARE CLINIC
COMMUNITY BLOOD BANK
1301 SOUTH CLIFF AVENUE SUITE 3	SIOUX FALLS	SD	57105	COMMUNITY BLOOD SERVICES
AVERA 69TH ST PHARMACY - BEHAVIORAL
4400 W 69TH ST SUITE 300	SIOUX FALLS	SD	57108	RETAIL PHARMACY
AVERA HOME MEDICAL EQUIPMENT
100 22ND AVENUE SUITE 101	BROOKINGS	SD	57006	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
PIPESTONE MEDICAL GROUP AVERA
920 - 4TH AVENUE SW	PIPESTONE	MN	56164	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP ESTHERVILLE
926 NORTH 8TH STREET	ESTHERVILLE	IA	51334	PRIMARY CARE CLINIC
RURAL MEDICAL CLINICS
301 SOUTH WALNUT STREET	FREEMAN	SD	57029	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP CHAMBERLAIN
101 SOUTH FRONT PO BOX 27	CHAMBERLAIN	SD	57325	PRIMARY CARE CLINIC
YORKSHIRE EYE CLINIC
2311 YORKSHIRE DRIVE	BROOKINGS	SD	57006	OPHTHALMOLOGY AND OPTOMETRY CLINIC
HEALTH CARE CLINIC
300 NORTH DAKOTA AVENUE SUITE 117	SIOUX FALLS	SD	57104	FREE HEALTHCARE CLINIC
AVERA MEDICAL GROUP BUTTE
730 WILSON STREET	BUTTE	NE	68722	SATELLITE PRIMARY CARE CLINIC
AVERA MEDICAL GROUP LAKEFIELD
221 - 3RD AVENUE	LAKEFIELD	MN	56150	SATELLITE PRIMARY CARE CLINIC
AVERA MEDICAL GROUP VOLGA
210 KASAN AVENUE	VOLGA	SD	57071	SATELLITE PRIMARY CARE CLINIC
AVERA MEDICAL GROUP ELKTON
203 ELK STREET	ELKTON	SD	57026	SATELLITE PRIMARY CARE CLINIC
AVERA MEDICAL GROUP FULDA
201 N ST PAUL AVENUE	FULDA	MN	56131	SATELLITE PRIMARY CARE CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (43 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: A COMBINATION OF INCOME AND ASSETS TEST IS UTILIZED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. POINTS ARE ASSIGNED BASED ON INCOME AS A PERCENTAGE OF FPG AND NET ASSETS OWNED WITH POINTS DEDUCTED FOR ONGOING MEDICAL EXPENSES SUCH AS DRUGS. PATIENTS WITH THE FEWEST POINTS RECEIVE THE LARGEST DISCOUNT. 0-1 POINTS RECEIVE 100% DISCOUNT ON BILLS WHILE REMAINING DISCOUNTS RANGE FROM 10-90% DEPENDING ON POINT TOTALS AND DOLLAR AMOUNT OF CHARGES.
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: A COMBINATION OF COSTING METHODOLOGY WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. A COST ACCOUNTING SYSTEM WAS USED TO CALCULATE MEDICAID AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES AND SHORTFALLS AND SUBSIDIZED HEALTH SERVICES FOR OUR TERTIARY MEDICAL CENTER. A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE CHARITY CARE AT COST FOR ALL ENTITIES AND MEDICAID AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES AND SHORTFALLS AND SUBSIDIZED HEALTH SERVICES FOR ANY OPERATIONS OUTSIDE OF THE TERTIARY MEDICAL CENTER. FOR ALL OTHER AMOUNTS, COSTS AND REVENUES AS REFLECTED BY THE GENERAL LEDGER SYSTEM WERE USED.
PART I, LINE 7G: PHYSICIAN CLINIC COSTS FOR BEHAVIORAL HEALTH SERVICES AND TRANSPLANT SERVICES ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES. REVENUES OF $7,378,224 AND COSTS OF $11,545,760 WERE INCLUDED FOR A NET COMMUNITY BENEFIT OF $4,167,536. OUTSIDE OF THE VETERANS ADMINISTRATION HOSPITAL, WE ARE THE SOLE PROVIDER OF HOSPITAL BEHAVIORAL HEALTH SERVICES TO THE COMMUNITY, OF WHICH THE CLINICS ARE AN INTEGRAL PART OF THESE SERVICES. OUR FACILITY IS ALSO THE PRINCIPAL PROVIDER OF TRANSPLANT SERVICES THROUGHOUT OUR SERVICE AREA AND THE CLINICS ARE A CRUCIAL COMPONENT OF SUCCESSFUL PRE AND POST TRANSPLANT CARE.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $18,283,341 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
PART II: ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, AND COALITION BUILDING ARE SUPPORTED MAINLY THROUGH MONETARY DONATIONS IN ADDITION TO SERVICE PREPAREDNESS COMMITTEES. THE ORGANIZATION'S WORKFORCE DEVELOPMENT PROGRAM WORKS WITH UNIVERSITIES, TECHNICAL SCHOOLS, AND LOCAL HIGH SCHOOLS TO ADDRESS HEALTHCARE WORKER SHORTFALLS IN THE COMMUNITY. THROUGH PARTNERING WITH THESE ORGANIZATIONS, AVERA MCKENNAN PROVIDES SPEAKERS, WORK EXPERIENCE FOR STUDENTS, SHADOWING, CAREER FAIRS AND INFORMATIONAL LITERATURE TO ENCOURAGE STUDENTS TO CONSIDER A CAREER IN HEALTHCARE AND STAY IN THE COMMUNITY.
PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION.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.NOTE FROM FINANCIAL STATEMENT:PATIENT AND RESIDENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT, RESIDENT AND THIRD-PARTY PAYOR OBLIGATIONS. UNPAID PATIENT AND RESIDENT RECEIVABLES, EXCLUDING AMOUNTS DUE FROM THIRD-PARTY PAYORS, WITH INVOICE DATES OVER 90 DAYS OLD HAVE INTEREST ASSESSED AT 1 PERCENT PER MONTH. THESE INTEREST CHARGES ARE RECOGNIZED AS INCOME WHEN CHARGED. PAYMENTS OF PATIENT AND RESIDENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM.PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS.MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE ORGANIZATION'S PROCESS FOR CALCULATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS HAS NOT SIGNIFICANTLY CHANGED BETWEEN THE YEARS ENDED JUNE 30, 2012 AND 2011. THE ORGANIZATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE OFFS FROM THIRD-PARTY PAYORS. THE ORGANIZATION CHANGED ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES DURING THE YEARS ENDED JUNE 30, 2012 AND 2011 RELATED TO UNINSURED PATIENTS TO COMPLY WITH NEW REGULATORY REQUIREMENTS ISSUED BY THE INTERNAL REVENUE SERVICE. THE CHANGES DID NOT HAVE A MATERIAL IMPACT ON CONSOLIDATED FINANCIAL STATEMENT AMOUNTS OR DISCLOSURES.PART III, LINES 5, 6, AND 7: THE MEDICARE REVENUES RECEIVED (LINE 5), ALLOWABLE COSTS (LINE 6), AND THE RESULTING SURPLUS (LINE 7) DOES NOT INCLUDE A SIGNIFICANT PORTION OF THE ORGANIZATION'S EXPENSES. THESE LINES REQUIRE USE OF THE MEDICARE COST REPORT AS PREPARED BY THE REQUIRED GUIDELINES WHICH DISALLOWS NUMEROUS COSTS OF HOSPITALS, PARTICULARLY IF THEY ARE PART OF AN INTEGRATED SYSTEM SUCH AS AVERA MCKENNAN. IN THESE CASES THE ENTITY MUST FILE A HOME OFFICE COST REPORT WHICH "STEPS DOWN" OVERHEAD TO NON-COST REPORT ENTITIES DISPROPORTIONATELY TO ACTUAL ALLOWABLE SHARE AND ESSENTIALLY REMOVING THE COSTS FROM THE HOSPITAL'S COST REPORT ENTIRELY. EXAMPLES OF A PORTION OF THESE OVERHEAD COSTS WOULD BE FINANCE, BUSINESS OFFICE, INFORMATION TECHNOLOGY, HUMAN RESOURCES AND ADMINISTRATION. EXAMPLES OF NON-COST REPORT ENTITIES OPERATED BY AVERA MCKENNAN INCLUDE CLINICS, HOME MEDICAL EQUIPMENT STORES, MOBILE IMAGING SERVICES, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES. THERE ARE ALSO COSTS COMPLETELY DISALLOWED BY COST REPORT RULES SUCH AS BAD DEBT EXPENSE, HOSPITALISTS CARE, MARKETING, CRNA'S, AND INTEREST EXPENSE. AVERA MCKENNAN ALSO RECEIVES A MEDICARE DISPROPORTIONATE SHARE HOSPITAL (DSH) ADJUSTMENT AS PART OF THE COST REPORT DUE TO THE ITS SIGNIFICANT NUMBER OF LOW-INCOME PATIENTS SERVED. PART III, LINE 5 REQUIRES INCLUSION OF THIS REVENUE THOUGH EXPENSES INCLUDED ARE MUCH LOWER. SCHEDULE H INSTRUCTIONS ALSO REQUIRE THE EXCLUSION OF $10,405,711 OF MEDICARE LOSSES BECAUSE THEY ARE INCLUDED IN SCHEDULE H, PART 1, LINE 7G. INCLUDING THE MEDICARE PERCENTAGE OF DISALLOWED COSTS, ENTITIES WHICH DO NOT FILE A COST REPORT BUT NEVERTHELESS CARE FOR MEDICARE PATIENTS, AND THE IMPACT OF THE HOME OFFICE COST REPORT, THE MEDICARE SHORTFALL IS $18,137,186 AS OPPOSED TO A SURPLUS OF $19,436,837.
PART III, LINE 8: AVERA MCKENNAN FOLLOWS THE CATHOLIC HEALTH ASSOCIATION GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL (AS CALCULATED INCLUDING OUR NON-COST REPORT ENTITIES) IS EXCLUDED FROM OUR COMMUNITY BENEFIT REPORT. HOWEVER, MEDICARE IS THE ORGANIZATION'S LARGEST PAYER AND PATIENTS WITH MEDICARE COVERAGE ARE ACCEPTED REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED FROM PROVIDING THE SERVICES. THIS BASIS THEREFORE MEANS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A KEY ADVANTAGE FOR OUR COMMUNITY.MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS.
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 IT'S AGENT SHALL NOT SEND, NOR SUGGEST THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE 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 DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES; HOWEVER, THE COLLECTION AGENCIES AVERA UTILIZES MAY REPORT TO THE CREDIT AGENCIES. ANY EXTENDED PAYMENT PLANS OFFERED BY A HOSPITAL IN SETTLING THE OUTSTANDING BILLS OF LOW INCOME, UNINSURED PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA MCKENNAN
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	HEART HOSPITAL OF SOUTH DAKOTA, LLC
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA GREGORY HEALTHCARE CENTER
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA MILBANK AREA HOSPITAL
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA DELLS AREA HEALTH CENTER
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA FLANDREAU MEDICAL CENTER
PART V, SECTION B, LINE 13G: A SUMMARY OF THE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOM OR WAITING ROOMS, ADMISSIONS OFFICES, AND IS PROVIDED, IN WRITTING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY.	AVERA HAND COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA MCKENNAN
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	HEART HOSPITAL OF SOUTH DAKOTA, LLC
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA GREGORY HEALTHCARE CENTER
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA MILBANK AREA HOSPITAL
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA DELLS AREA HEALTH CENTER
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA FLANDREAU MEDICAL CENTER
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED TO A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY FOR EMERGENCY AND MEDICALLY NECESSARY CARE IS 90% OF THE GROSS CHARGES. THIS IS BASED ON THE LOWEST DISCOUNT UNDER THE CHARITY CARE POLICY OF 10%.	AVERA HAND COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA MCKENNAN
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	HEART HOSPITAL OF SOUTH DAKOTA, LLC
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA GREGORY HEALTHCARE CENTER
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA MILBANK AREA HOSPITAL
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA DELLS AREA HEALTH CENTER
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA FLANDREAU MEDICAL CENTER
PART V, SECTION B, LINE 20: THE HOSPITAL PROVIDES A REDUCTION TO GROSS CHARGES UNDER THEIR FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS NOT DETERMINED THE AMOUNT GENERALLY BILLED UNDER THE VARIOUS PROPOSED METHODS OF CALCULATION. THEREFORE, IT IS POSSIBLE A PATIENT UNDER THE FINANCIAL ASSISTANCE POLICY COULD HAVE PAID MORE THAN THE AMOUNT GENERALLY BILLED. THE HOSPITAL WILL REVIEW THE VARIOUS METHODS TO ENSURE APPROPRIATE DISCOUNTS ARE PROVIDED TO EQUAL OR EXCEED THE AMOUNTS GENERALLY BILLED TO THOSE WITH INSURANCE.	AVERA HAND COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 21: 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 MCKENNAN
PART V, SECTION B, LINE 21: 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.	HEART HOSPITAL OF SOUTH DAKOTA, LLC
PART V, SECTION B, LINE 21: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.	AVERA GREGORY HEALTHCARE CENTER
PART V, SECTION B, LINE 21: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.	AVERA MILBANK AREA HOSPITAL
PART V, SECTION B, LINE 21: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.	AVERA DELLS AREA HEALTH CENTER
PART V, SECTION B, LINE 21: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.	AVERA FLANDREAU MEDICAL CENTER
PART V, SECTION B, LINE 21: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.	AVERA HAND COUNTY MEMORIAL HOSPITAL
PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENT OCCURS AT VARIOUS POINTS IN THE SYSTEM. THROUGH ANNUAL STRATEGIC PLANNING SESSIONS, COMMUNITY LEADERS ARE BROUGHT IN TO UPDATE AND EDUCATE AVERA MCKENNAN BOARD MEMBERS AND ADMINISTRATIVE COUNCIL ON THE SUCCESSES, CHALLENGES, AND SERVICE GAPS IN THE COMMUNITY. EXAMPLES INCLUDE SCHOOL DISTRICT OFFICIALS, STATE HEALTH DEPARTMENT, AND COMMUNITY HEALTH ORGANIZATIONS. LEADERS ALSO SERVE ON BOARDS OF VARIOUS COMMUNITY ORGANIZATIONS WHICH SEEK TO ADDRESS THE HEALTH AND WELL-BEING OF AREA CITIZENS. LOCAL GOVERNING BOARDS AT OUTLYING FACILITIES, WHO ARE MEMBERS OF THE COMMUNITY, DISCUSS AND HELP DIRECT RESOURCES TO AREAS OF TARGETED NEEDS AS WELL.
PART VI, LINE 3: NOTICES ARE POSTED IN ENGLISH AND SPANISH IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND OUTPATIENT SERVICE SETTINGS AS WELL AS THE ORGANIZATION WEBSITE. POSTED NOTICES STATE THAT THE ORGANIZATION HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR CHARITY CARE AND REDUCED-PAYMENT FOR HEALTHCARE SERVICES. THERE IS ALSO IDENTIFICATION OF A CONTACT PHONE NUMBER THAT A PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ABOUT HOW TO APPLY FOR SUCH ASSISTANCE. ADDITIONALLY, ADMITTING STAFF MAKES AVAILABLE A BROCHURE DESIGNED TO HELP PATIENTS UNDERSTAND HOW WE BILL PATIENTS AND PROVIDES SUMMARY INFORMATION ON FINANCIAL ASSISTANCE IF YOU ARE UNABLE TO PAY. PATIENT ADVOCATES WORK WITH UNINSURED PATIENTS IN OUR MAIN TERTIARY FACILITY TO ENROLL THEM IN APPLICABLE SOCIAL PROGRAMS AND IDENTIFY CHARITY ELIGIBILITY, ELIGIBILITY AND ENROLLMENT FOR COUNTY, STATE OR FEDERAL RISK POOLS, AND ELIGIBILITY FOR MODIFIED MEDICARE OR MEDICAID PROGRAMS.
PART VI, LINE 4: AVERA MCKENNAN'S SERVICE AREA IS A LARGELY RURAL POPULATION. SERVICES ARE PROVIDED THROUGH A HEALTH CARE NETWORK OF 117 LOCATIONS COVERING 54 COMMUNITIES IN FOUR STATES. THE MAIN TERTIARY FACILITY IS LOCATED IN A POPULATION CENTER OF OVER 155,000 SERVED BY ANOTHER NON-PROFIT HOSPITAL OF SIMILAR SIZE, VETERANS ADMINISTRATION HOSPITAL, A HOSPITAL DEDICATED TO DIAGNOSIS AND TREATMENT OF HEART DISEASE, AND A HOSPITAL FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. OUTSIDE OF THIS POPULATION CENTER, MOST OF THE COMMUNITIES SERVED HAVE LESS THAN 4,000 RESIDENTS. THE PRIMARY SERVICE AREA INCLUDES FOUR COUNTIES COVERING APPROXIMATELY 2,600 SQUARE MILES AND CONTAINS SEVEN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. THE U.S. CENSUS BUREAU DATA ESTIMATES JUST UNDER 10% OF RESIDENTS IN THE PRIMARY SERVICE AREA ARE AT OR BELOW THE POVERTY LEVEL. OUR SECONDARY SERVICE AREA COVERS AN ADDITIONAL 19 COUNTIES IN SOUTH DAKOTA, IOWA AND MINNESOTA WITH AN ESTIMATED TOTAL POPULATION OF 235,000 BASED ON U.S. CENSUS BUREAU PROJECTIONS FOR 2011.
PART VI, LINE 5: SURPLUS FUNDS ARE REINVESTED IN FACILITIES TO IMPROVE PATIENT CARE.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE AVERA MCKENNAN BOARD OF TRUSTEES IS PRINCIPALLY COMPRISED OF COMMUNITY MEMBERS FROM THE PRIMARY SERVICE AREA. MEMBERS COME FROM A VARIETY OF BACKGROUNDS RANGING FROM PRIVATE INDUSTRY AND BANKING TO HEALTHCARE.AVERA MCKENNAN IS A VERIFIED LEVEL II TRAUMA CENTER AND WAS THE FIRST SUCH CENTER IN THE STATE OF SOUTH DAKOTA. AVERA MCKENNAN'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY WITH BOARD-CERTIFIED EMERGENCY SPECIALISTS AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. OPERATING BOTH FIXED WING AND HELICOPTER MEDICAL AIR TRANSPORTS, AVERA MCKENNAN'S FLIGHT TEAMS COVER A LARGE GEOGRAPHIC AREA PROVIDING STATE-OF-THE-ART AIR TRANSPORT SERVICES AND ACCESS TO CRITICAL CARE.THROUGH AN INTEGRATED NETWORK OF CLINIC PROVIDERS THE ORGANIZATION PROVIDES NON-EMERGENCY SERVICES TO THE COMMUNITITES IT SERVES. IT MAKES THESE SERVICES ACCESSIBLE TO THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID.AVERA MCKENNAN OWNS OR LEASES RURAL CRITICAL ACCESS HOSPITALS IN FLANDREAU, GREGORY, DELL RAPIDS, MILBANK AND MILLER (HAND COUNTY), S.D. AS SUCH, THEY OPERATE AS A DEPARTMENT OF AVERA MCKENNAN. THE HOSPITALS IN FLANDREAU, GREGORY AND HAND COUNTY SERVE MEDICALLY UNDERSERVED COUNTIES. IN ADDITION TO THE FOLLOWING EXEMPT PURPOSE ACHIEVEMENTS, RURAL HOSPITALS PARTICIPATE IN MANY OF THE ABOVE AS PART OF AVERA MCKENNAN.AMONG SERVICES OFFERED BY RURAL HOSPITALS ARE RADIOLOGY AND IMAGING, COLONOSCOPY AND ENDOSCOPY, THERAPY AND REHABILITATION, 24-HOUR EMERGENCY CARE, CHEMOTHERAPY, ORTHOPEDICS, CARDIOVASCULAR TESTING AND CARE, OBSTETRICS, SURGERY, AND DIALYSIS. EACH OF THE HOSPITALS PROVIDES 24-HOUR EMERGENCY CARE WITH EEMERGENCY SERVICES THROUGH AVERA MCKENNAN. EICU SERVICES ARE ALSO AVAILABLE AT THESE HOSPITALS, PROVIDING ACCESS TO CRITICAL CARE MEDICINE NEAR HOME AND LESSENING THE NEED FOR TRANSPORT. THERE IS NO ADDITIONAL BILLING TO PATIENTS. TELEMEDICINE CONSULTS ARE ALSO OFFERED AT RURAL LOCATIONS IN A NUMBER OF MEDICAL SPECIALTIES.HEALTH CARE CLINIC: IN 1992, AVERA MCKENNAN ESTABLISHED A HEALTH CARE CLINIC TO PROVIDE FREE CARE FOR PEOPLE WHO ARE UNINSURED OR UNDERINSURED IN THE COMMUNITY. THE CLINIC IS MANAGED BY A REGISTERED NURSE AND STAFFED BY REGISTERED NURSES, TWO MIDLEVEL PROVIDERS, MEDICAL RESIDENTS AND VOLUNTEER HEALTH CARE PROVIDERS. THE GOAL OF THE CLINIC IS TO PREVENT OR TREAT PATIENTS' MEDICAL CONDITIONS BEFORE THEY BECOME CATASTROPHIC. THE CLINIC AVERAGES 694 VISITS PER MONTH, PROVIDING PREVENTATIVE CARE, DIAGNOSIS AND TREATMENT OF ILLNESSES AND INJURIES, MEDICATION ASSISTANCE AND ASSISTANCE IN OBTAINING SPECIALIST CARE FOR PATIENTS WITH COMPLEX CASES. THE CLINIC ALSO SERVES TO TRAIN PHYSICIANS, NURSES AND OTHER HEALTH CARE STUDENTS. IT PROVIDES A FREE EVENING CLINIC ONE EVENING PER MONTH, STAFFED BY MEDICAL STUDENTS UNDER SUPERVISION OF PHYSICIANS. AVERA MCKENNAN IS THE ONLY HEALTH CARE ORGANIZATION TO PROVIDE FREE SERVICES SUCH AS THIS IN THE STATE OF SOUTH DAKOTA. THE CLINIC HAD 8,329 VISITS IN 2012, AND WAS OPERATED AT AN ANNUAL COST OF $704,303. AVERA MCKENNAN PARTNERS WITH THE NOT-FOR-PROFIT DESTINY CLINIC BY PROVIDING FUNDING OF $13,000 PER YEAR TO PROVIDE FREE EVENING CLINIC SERVICES.RESIDENCY/HEALTH PROFESSIONS TRAINING AND INTERNSHIPS: IN 2012, AVERA MCKENNAN HAD 90 MEDICAL SCHOOL RESIDENTS IN TRAINING AT AVERA MCKENNAN IN INTERNAL MEDICINE, FAMILY PRACTICE, PSYCHIATRY, GERIATRICS AND TRANSITIONAL RESIDENCY PROGRAMS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE. OVER 800 STUDENTS IN NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, RADIOLOGY AND RESPIRATORY THERAPY ALSO COMPLETED ROTATIONS AT AVERA MCKENNAN. AVERA MCKENNAN HAS MANY JOINT AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION FOR BOTH CLINICAL AND EDUCATIONAL PROGRAMMING. IN NON-CLINICAL AREAS, AVERA MCKENNAN OFFERED 42 UNPAID INTERNSHIPS IN 2012 IN THE AREAS OF MARKETING, HUMAN RESOURCES, FOUNDATION, NETWORK OPERATIONS AND PROCESS EXCELLENCE, WORKING WITH APPROXIMATELY 17 INSTITUTIONS OF HIGHER EDUCATION.COMMUNITY EDUCATION: AVERA MCKENNAN IS A REGIONAL LEADER IN OFFERING EDUCATIONAL PROGRAMS FOR A VARIETY OF LEARNERS, LEADERS AND EMPLOYEES. UTILIZING ADVANCED TECHNOLOGY, MANY OF THESE PROGRAMS ARE PROVIDED ELECTRONICALLY THROUGHOUT THE TRI-STATE AREA. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS AT ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING AVERA MCKENNAN'S EDUCATION CENTER, A BROAD CROSS-SECTION OF CLASSES INVOLVING DIVERSE AUDIENCES ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR.TO BE WELL FREE EDUCATION EVENTS WERE HELD ON TOPICS INCLUDING ORTHOPEDICS, CANCER, DIABETES, WEIGHT LOSS/HEALTHY EATING, MULTIPLE SCLEROSIS, ANXIETY AND ACUPUNCTURE. FORUMS: THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE FRIDAY FORUMS, IN WHICH SCHOOL COUNSELORS AND THERAPISTS ARE INVITED TO PRESENTATIONS ON CHILDREN'S MENTAL HEALTH TOPICS SUCH AS CONFLICT CYCLES, REACTIVE ATTACHMENT DISORDER, DEPRESSION AND BIPOLAR DISORDER IN CHILDREN, AND TEEN SUBSTANCE USE, ABUSE AND ADDICTION. THESE SESSIONS, HELD NINE TIMES EACH YEAR, ARE ATTENDED IN PERSON BY APPROXIMATELY 85. THROUGHOUT 2012, VIDEOS OF THESE PRESENTATIONS WERE VIEWED 396 TIMES ONLINE.THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE MONTHLY EDUCATIONAL SESSIONS ON VARIOUS TOPICS FOLLOWED BY DISCUSSION FOR ADULTS WHO HAVE BEEN IMPACTED BY A LOVED ONE'S MENTAL ILLNESS. TOPICS HAVE INCLUDED GRIEF AND LOSS, ANXIETY, AND PARENTING STRATEGIES FOR MANAGING CHALLENGING BEHAVIORS.WOMEN'S & CHILDREN'S SERVICES: AVERA MCKENNAN'S WOMEN'S & CHILDREN'S SERVICES OFFERS A NUMBER OF PARENTING AND COMMUNITY EDUCATION OPPORTUNITIES, FOR FREE OR AT A MINIMAL COST. IN FISCAL YEAR 2012, 166 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 1,053 ATTENDEES. A TOTAL OF 36 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 307 ATTENDEES. A TOTAL OF 135 CAR SEATS WERE ISSUED THROUGH PROJECT 8, SOUTH DAKOTA GOVERNOR'S CHILD SEAT PROGRAM WITH TRAINING ON THEIR CORRECT USE. FREE BURN EDUCATION WAS PROVIDED TO 2,516 STUDENTS DURING PRESENTATIONS IN SCHOOLS.DAYCARE TRAINING: FREE OF CHARGE, AVERA MCKENNAN OFFERS FOUR IN-SERVICE TRAINING SESSIONS PER MONTH TO DAYCARE PROVIDERS THROUGH THE YWCA, WITH A TOTAL OF 36 SCHEDULED ANNUALLY, AND ADDITIONAL SESSIONS FOR REQUESTED TOPICS. SUPPORT GROUPS: AVERA MCKENNAN OFFERS APPROXIMATELY 10 FREE SUPPORT GROUPS. THEY RANGE IN TOPIC FROM CANCER TO LIVER DISEASE, DIABETES, BONE MARROW TRANSPLANT, STROKE AND GRIEF AND LOSS. THE ORGANIZATION PROVIDES FREE MEETING SPACE AS WELL AS SPEAKERS AND LEADERS. INFORMATION AND ASSISTANCE: AVERA MCKENNAN OPERATES A 24-HOUR MEDICAL CALL CENTER, THROUGH WHICH PATIENTS HAVE ACCESS TO THE ASK-A-NURSE PROGRAM. PATIENTS CAN CALL A TOLL-FREE NUMBER AND TALK PERSONALLY WITH A REGISTERED NURSE TO ASK HEALTH QUESTIONS OR RECEIVE GENERAL HEALTH INFORMATION. IN 2012, THE MEDICAL CALL CENTER HANDLED 99,000 CALLS. AVERA MCKENNAN'S WEB SITE ALSO PROVIDES AN EXTENSIVE HEALTH LIBRARY THAT CONSUMERS CAN ACCESS FREE OF CHARGE.INTERPRETER SERVICE: AVERA MCKENNAN EMPLOYS TWO FULL-TIME SPANISH INTERPRETERS IN-HOUSE, AND THEIR SERVICES ARE OFFERED TO PATIENTS FREE OF CHARGE. IN ADDITION, IN COOPERATION WITH EXTERNAL AGENCIES, AVERA MCKENNAN IS ABLE TO HANDLE 99 DIFFERENT LANGUAGES AND DIALECTS. AVERA MCKENNAN CONTRACTS FOR AN INBOUND CALL-IN SERVICE FOR SPANISH SPEAKING INDIVIDUALS. THIS IS AVAILABLE AT THE MAIN HOSPITAL SWITCHBOARD, AS WELL AS AVERA MCGREEVY CLINIC AND AVERA WOMEN'S CLINIC. ALL THE ABOVE SERVICES ARE PROVIDED AT NO COST TO THE PATIENT.PRENATAL AND DELIVERY CARE: BECAUSE EARLY AND REGULAR PRENATAL CARE IS IMPORTANT TO PREVENT PREMATURE BIRTH, AVERA MCKENNAN COLLABORATES IN A COMMUNITY EFFORT TO PROVIDE OBSTETRICS CARE FOR WOMEN WHO DO NOT QUALIFY FOR MEDICAID, BUT CANNOT AFFORD HEALTH INSURANCE. THE PROGRAM OFFERS PRENATAL CARE, AND HOSPITAL LABOR AND DELIVERY SERVES FOR A LOW FEE OF $1,000. WOMEN RECEIVE CARE WHETHER THEY CAN COVER ANY OR ALL OF THE FEE. CARE IS PROVIDED PRIMARILY BY FIRST-YEAR FAMILY PRACTICE RESIDENTS, SUPERVISED BY EXPERIENCED PHYSICIANS. THROUGH THIS PROGRAM IN 2012, AVERA MCKENNAN ASSISTED WITH 81 BIRTHS AND PROVIDED 823 PRENATAL AND POST-PARTUM VISITS.
TRANSPORT TO TRANSPLANT: AVERA MCKENNAN DEVELOPED THE TRANSPORT TO TRANSPLANT PROJECT, WHICH REMOVES TRANSPORTATION BARRIERS FOR PATIENTS FROM RURAL AREAS WHICH MAY PREVENT THEM FROM COMPLETING THE EVALUATION AND TESTING NEEDED FOR KIDNEY AND/OR PANCREAS TRANSPLANT. A VAN FUNDED THROUGH A GRANT FROM THE AVERA MCKENNAN FOUNDATION IS USED TO TRANSPORT PATIENTS WHO DEMONSTRATE A FINANCIAL NEED. PATIENTS ARE BROUGHT TO THE AVERA TRANSPLANT INSTITUTE FOR A CONDENSED MULTI-DAY EVALUATION WITH ALL TESTING AND VISITS COMPLETED IN LESS THAN ONE WEEK. ULTIMATELY, THE PROJECT RESULTS IN IMPROVED MORBIDITY AND MORTALITY, AS KIDNEY TRANSPLANT DOUBLES PATIENT SURVIVAL AS COMPARED TO REMAINING ON DIALYSIS.AVERA FAMILY WELLNESS: THIS PROGRAM COMBINES POSITIVE ACTIVITIES LIKE VIOLIN LESSONS WITH FAMILY COACHING AT NO CHARGE FOR CHILDREN IN EARLY CHILDHOOD PROGRAMS IN THE SIOUX FALLS SCHOOL DISTRICT. THE GOAL IS TO PREVENT OR LESSEN THE EFFECTS OF BEHAVIORAL HEALTH CONDITIONS ON CHILDREN AND FAMILIES BY FOSTERING A POSITIVE ENVIRONMENT. APPROXIMATELY 200 STUDENTS ARE ENROLLED.THE WALSH FAMILY VILLAGE: THIS HOSPITALITY HOUSE COMPLEX ADJACENT TO THE AVERA MCKENNAN CAMPUS PROVIDES A HOME AWAY FROM HOME FOR PATIENTS AND THEIR FAMILIES WHO COME FOR CARE AT AVERA MCKENNAN FROM OUTSIDE OF SIOUX FALLS. THE PROJECT WAS FUNDED BY DONATIONS AND IS OPERATED BY AVERA MCKENNAN. ELEVEN GUEST ROOMS ARE AVAILABLE. AVERA MCKENNAN ALSO DONATES USE OF A BUILDING IN THE COMPLEX FOR A RONALD MCDONALD HOUSE FOR FAMILIES OF PEDIATRIC PATIENTS. IF THEY CAN AFFORD IT, GUESTS ARE CHARGED A LOW FEE OF $46.50 PER NIGHT. IF THEY CANNOT AFFORD THE EXPENSE, THE COST OF THE ROOM IS WAIVED. EMPLOYEES REGULARLY DONATE NON-PERISHABLE FOOD ITEMS TO STOCK A FOOD PANTRY FOR GUESTS. IN 2012, THE WALSH FAMILY VILLAGE SERVED 7,018 GUESTS, STAYING IN 4,026 NIGHTLY ROOMS - A 92 PERCENT OCCUPANCY. AVERA MCKENNAN PROVIDES A SUBSIDY OF APPROXIMATELY $260,000 PER YEAR TO OPERATE THE HOSPITALITY COMPLEX.PREVENTION AND SUPPORT OF SUBSTANCE USE DISORDER: AVERA MCKENNAN IS A PARTNER WITH FACE IT TOGETHER SIOUX FALLS, A NONPROFIT ORGANIZATION WHICH SERVES AS THE LOCAL FACE AND VOICE FOR RECOVERY FROM ADDICTION THROUGH ITS RECOVERY SUPPORT SERVICES, ADVOCACY AND AWARENESS PROGRAMS. AVERA HAS BEEN A PARTNER WITH FACE IT TOGETHER SINCE ITS INCEPTION, AND IN A RECENT AWARENESS CAMPAIGN. IN 2012, AVERA MCKENNAN PROVIDED $50,000 IN FUNDING TOWARD THIS EFFORT.SUPPORT OF INDIAN RESERVATIONS: IN 2012, AVERA MCKENNAN DELIVERED ONE TRUCKLOAD OF EXCESS MEDICAL EQUIPMENT, FURNITURE AND SUPPLIES TO INDIAN RESERVATIONS IN SOUTH DAKOTA, AND SUPPORTED A CHRISTMAS PARTY FOR CHILDREN.COMMUNITY CONNECTIONS: AVERA MCKENNAN REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT EASTERN SOUTH DAKOTA, SOUTHWESTERN MINNESOTA AND NORTHWEST IOWA THROUGH HOME TOWN CONNECTIONS. PROVIDING A CRITICAL FEEDBACK LINK TO LOCAL REFERRING DOCTORS, THIS PROGRAM COMPLETES THE COMMUNICATIONS LINKS NECESSARY TO KEEP LOCAL HEALTH CARE PROVIDERS CURRENT ON THE TREATMENT OF THEIR PATIENTS AT AVERA MCKENNAN.SUPPORT OF THE ARTS AND CULTURAL LIFE: AVERA MCKENNAN HOSTS SIOUX FALLS' ONLY INDOOR SCULPTUREWALK, AN EXTENSION OF THE COMMUNITY'S DOWNTOWN SCULPTUREWALK. ARTISTS DONATE SCULPTURES FOR ONE YEAR, WHICH ARE PLACED AT LOCATIONS THROUGHOUT AVERA MCKENNAN'S CAMPUS, IN BUILDINGS CONNECTED BY SKYWALKS. BROCHURES CONTAIN A MAP, AND VISITORS WHO FOLLOW THE ROUTE SUGGESTED WALK APPROXIMATELY 1 MILE, MAKING THIS A HEALTHY AS WELL AS A CULTURAL JOURNEY.DIABETES PROGRAMMING: AVERA PARTICIPATES IN A COLLABORATIVE PROJECT WITH SIOUX FALLS PUBLIC SCHOOLS AND THE SOUTH DAKOTA BOARD OF NURSING TO IMPLEMENT ECONSULT SERVICES WITH DIABETIC EDUCATION SPECIALISTS MONITORING MEDICATIONS AND THE HEALTH OF CHILDREN WITH DIABETES IN THE SCHOOL SETTING. AVERA MCKENNAN DIABETES EDUCATORS PROVIDED CLASSES AND ONE-ON-ONE CONSULTATIONS AT A LOSS OF $648,744 IN THE PAST FISCAL YEAR.COMMUNITY BENEFITS: AVERA MCKENNAN PROVIDES ADDITIONAL COMMUNITY BENEFITS INCLUDING: SUPPORT OF YOUTH PROGRAMS; HOMELESS PROGRAMS; COMMUNITY ARTS PROGRAMMING; HEALTH PREVENTION; AWARENESS AND EDUCATION ABOUT CANCER, HEART DISEASE AND OTHER CONDITIONS; AND SUPPORT OF THE SIOUX EMPIRE UNITED WAY AND OTHER SERVICES IN THE REGION. DONATIONS TOWARD THESE EFFORTS TOTALED $1,858,000 IN 2012.PRESCHOOL VISION AND HEARING SCREENING: AVERA MCKENNAN PROVIDED FREE SCREENING FOR 347 PRESCHOOL CHILDREN IN FISCAL YEAR 2012.MEDICAL RESEARCH: AS A RESEARCH INSTITUTION, AVERA MCKENNAN DRAWS PHYSICIANS WHO ARE COMMITTED TO SEEKING NEW TREATMENTS AND PREVENTIVE MEASURES. THE AVERA RESEARCH INSTITUTE IS CURRENTLY CONDUCTING PRE-CLINICAL RESEARCH TO ADD TO THE BODY OF MEDICAL KNOWLEDGE IN THE AREAS OF KIDNEY DISEASE LINKED TO OBESITY, KIDNEY FILTRATION AND GROWTH, AND NEUROSCIENCE RESEARCH IN REGARD TO STRESS AND ADDICTION. THE AVERA RESEARCH INSTITUTE ALSO CONTINUES ONGOING APPLIED RESEARCH IN THE AREA OF DEVELOPING A NOVEL PHOTOCHEMICAL TISSUE BONDING TECHNOLOGY THAT HAS OPHTHALMOLOGIC AND DERMATOLOGICAL APPLICATIONS. THROUGH ITS GENETICS LAB, AVERA MCKENNAN IS STUDYING GENETIC PRECURSORS OF MENTAL HEALTH CONDITIONS, WHICH HAS WIDE APPLICATION IN BOTH THE CLINICAL AND RESEARCH ARENAS. THE AVERA RESEARCH INSTITUTE IN 2012 PARTICIPATED IN 90 CLINICAL TRIALS, INVOLVING CANCER, ALZHEIMER'S DISEASE, HYPERCHOLESTEROLEMIA, RHEUMATOID ARTHRITIS, AND MORE. IN FISCAL YEAR 2012, AVERA MCKENNAN OPERATED THE AVERA RESEARCH INSTITUTE AT A LOSS OF $3,625,000.
THE COMMUNITIES IN WHICH THE AVERA SYSTEM OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFIT NEEDS AND IN KEEPING WITH THE CATHOLIC HEALTHCARE ASSOCIATION GUIDELINES EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE AVERA CENTRAL OFFICE ADVOCATES FOR ALL ON COMMUNITY BENEFIT-RELATED MATTERS OF STATE, REGIONAL, AND NATIONAL IMPORTANCE.		PART VI, LINE 6

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (52 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Address Line2AddressUS/AddressLine2
SOUTH DAKOTA STATE UNIVERSITY
PO BOX 2218	BROOKINGS	SD	57007	460273801	STATE OF SD	996593	DONATION
SIOUX FALLS CATHOLIC SCHOOLS
3100 W 41ST STREET	SIOUX FALLS	SD	57105	510145184	501(C)(3)	702150	DONATION
USD FOUNDATION
1100 N DAKOTA	VERMILLION	SD	57069	466018891	501(C)(3)	196000	DONATION
RONALD MCDONALD HOUSE
2001 S NORTON	SIOUX FALLS	SD	57105	460371152	501(C)(3)	25426	DONATION	155573	FMV	RENTED SPACE
CATHOLIC DIOCESE
523 N DULUTH AVE	SIOUX FALLS	SD	57104	466000424	501(C)(3)	127087	DONATION
SOUTH DAKOTA SYMPHONY
315 N MAIN AVE SUITE 204	SIOUX FALLS	SD	571046078	466017026	501(C)(3)	35000	DONATION
WASHINGTON PAVILION
PO BOX 984	SIOUX FALLS	SD	57101	460435791	501(C)(3)	55241	DONATION
YWCA
300 W 11TH STREET	SIOUX FALLS	SD	57104	460234998	501(C)(3)	17450	DONATION
TRANSITIONAL LIVING CORPORATION
2601 S MINNESOTA AVE	SIOUX FALLS	SD	571054742	200293050	501(C)(3)	30000	DONATION
AMERICAN CANCER SOCIETY
4904 S TECHNOPOLIS DRIVE	SIOUX FALLS	SD	57106	131788491	501(C)(3)	28160	DONATION
SIOUX EMPIRE UNITED WAY
1000 N WEST AVE 120	SIOUX FALLS	SD	57104	460233701	501(C)(3)	62500	DONATION
HARRISBURG ACTIVITIES FOUNDATION
PO BOX 479	HARRISBURG	SD	57032	061749081	501(C)(3)	40000	DONATION
SIOUX FALLS JAZZ & BLUES SOCIETY
123 S MAIN AVE SUITE 204	SIOUX FALLS	SD	571046430	460418356	501(C)(3)	10000	DONATION
SOUTH DAKOTA CHORALE
300 S MINNESOTA AVE	SIOUX FALLS	SD	57104	460225435	501(C)(3)	13000	DONATION
NATIONAL KIDNEY FOUNDATION
1100 E 21ST STREET AVERA DOCTORS	SIOUX FALLS	SD	57105	460448030	501(C)(3)	32000	DONATION				PLAZA 2 STE 210
NAMI OF SOUTH DAKOTA
PO BOX 88808	SIOUX FALLS	SD	57109	363593027	501(C)(3)	10000	DONATION
PRESENTATION SISTERS
1500 N 2ND ST	ABERDEEN	SD	57401	460253283	501(C)(3)	7500	DONATION
HELPLINE CENTER
1000 N WEST AVE STE 310	SIOUX FALLS	SD	57104	237424387	501(C)(3)	16500	DONATION
FAMILY VISITATION CENTER
311 E 14TH ST	SIOUX FALLS	SD	57104	263654937	501(C)(3)	8500	DONATION
SALES & MARKETING EXECUTIVES
PO BOX 90310	SIOUX FALLS	SD	57109	466012934	501(C)(6)	5000	DONATION
CHILDRENS CARE FOUNDATION
2501 W 26TH STREET	SIOUX FALLS	SD	57105	460233030	501(C)(3)	5000	DONATION
SOUTHEASTERN BEHAVIORAL HEALTH
2000 S SUMMIT AVE	SIOUX FALLS	SD	57105	460232306	501(C)(3)	5000	DONATION
ST MARY CATHOLIC SCHOOLS
812 N STATE AVE	DELL RAPIDS	SD	57022	466003662	501(C)(3)	5000	DONATION
AMYOTROPHIC LATERAL SCLEROSIS ASSOCIATION MINNESOTA CHAPTER
333 WASHINGTON AVE N STE 105	MINNEAPOLIS	MN	554011352	411756085	501(C)(3)	50000	DONATION
ZOOLOGICAL SOCIETY OF SIOUX FALLS GREAT PLAINS ZOO & MUSEUM
805 S KIWANIS AVE	SIOUX FALLS	SD	57104	466015015	501(C)(3)	15000	DONATION
CHILDRENS HOME FOUNDATION
PO BOX 1749	SIOUX FALLS	SD	571011749	460366277	501(C)(3)	31000	DONATION
MCCROSSAN BOYS RANCH
47135 260TH STREET	SIOUX FALLS	SD	57107	460311913	501(C)(3)	19334	DONATION
VOLUNTEERS OF AMERICA DAKOTAS
1401 W 51ST	SIOUX FALLS	SD	57105	237353508	501(C)(3)	5000	DONATION
SIOUX EMPIRE BASEBALL ASSOCIATION
1601 W 44TH PL SUITE 3	SIOUX FALLS	SD	57105	411903475	501(C)(3)	8667	DONATION
BOYS AND GIRLS CLUB OF BROOKINGS
307 6TH ST	BROOKINGS	SD	57006	731630215	501(C)(3)	5000	DONATION
HABITAT FOR HUMANITY OF GREATER SIOUX FALLS INC
721 E AMIDON ST	SIOUX FALLS	SD	57105	460407140	501(C)(3)	5000	DONATION
VISION BROOKINGS FOUNDATION
414 MAIN AVENUE	BROOKINGS	SD	57006	364585401	501(C)(3)	108237	DONATION
FORWARD SIOUX FALLS
PO BOX 907	SIOUX FALLS	SD	57101	460396647	501(C)(6)	17561	DONATION
DAKOTA SKY FOUNDATION
PO BOX 2464	SIOUX FALLS	SD	57101	208712140	501(C)(3)	25000	DONATION
DAKOTABILITIES INC
3600 S DULUTH AVE	SIOUX FALLS	SD	57105	460306216	501(C)(3)	23333	DONATION
SCULPTUREWALK INC
PO BOX 1165	SIOUX FALLS	SD	57101	208535871	501(C)(3)	23000	DONATION
CATHOLIC FOUNDATION FOR EASTERN SOUTH DAKOTA
523 N DULUTH AVE	SIOUX FALLS	SD	57104	466068924	501(C)(3)	15000	DONATION
SIOUX FALLS GREEN PROJECT
431 N PHILLIPS AVE 200	SIOUX FALLS	SD	57104	263820362	501(C)(3)	15000	DONATION
DESTINY HEALTHCARE INTERNATIONAL
2701 S MINNESOTA AVE 3	SIOUX FALLS	SD	57105	510529480	501(C)(3)	13000	DONATION
SIOUX FALLS AREA CHAMBER OF COMMERCE
PO BOX 1425	SIOUX FALLS	SD	57101	460189300	501(C)(6)	10945	DONATION
DOWNTOWN SIOUX FALLS INC
230 S PHILLIPS AVE STE 102	SIOUX FALLS	SD	57104	363627217	501(C)(4)	10000	DONATION
SIOUX FALLS SCHOOL DISTRICT
201 E 38TH ST	SIOUX FALLS	SD	57105	466002586	CITY OF SIOUX FALLS	10000	DONATION
SOUTH DAKOTA PARKS AND WILDLIFE FOUNDATION
523 E CAPITOL AVE	PIERRE	SD	57501	460387968	501(C)(3)	10000	DONATION
BROOKINGS SCHOOL DISTRICT
530 ELM AVE	BROOKINGS	SD	57006	466000834	CITY OF BROOKINGS	7950	DONATION
BLACK HILLS PLAYHOUSE INC
PO BOX 2513	RAPID CITY	SD	57709	460215866	501(C)(3)	5000	DONATION
THE GOOD SHEPHERD MINISTRY CENTER INC
300 N MAIN AVE	SIOUX FALLS	SD	57104	911836528	501(C)(3)	5000	DONATION
CITY OF GREGORY
PO BOX 436	GREGORY	SD	57533	466000175	CITY OF GREGORY	5000	DONATION
JUVENILE DIABITES RESEARCH FOUNDATION INTERNATIONAL
26 BROADWAY 14TH FLOOR	NEW YORK	NY	10004	231907729	501(C)(3)	5000	DONATION
MID-CENTRAL EDUCATIONAL COOPERATIVE
PO BOX 228	PLATTE	SD	57369	460365249		5000	DONATION
MINNEHAHA COUNTY HISTORICAL SOCIETY
200 W 6TH ST	SIOUX FALLS	SD	57104	466011931	501(C)(3)	5000	DONATION
MARCH OF DIMES BIRTH DEFECTS FOUNDATION SOUTH DAKOTA
1320 S MINNESOTA AVE	SIOUX FALLS	SD	57105	460340226	501(C)(3)	5000	DONATION
SOUTH DAKOTA PSYCHOLOGICAL ASSOCIATION
105 S EUCLID AVE STE C	PIERRE	SD	57501	460366504	501(C)(6)	5000	DONATION

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	46	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	6	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	56	NumberOfRecipients
Amount Of Cash Grant	125000	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: THE GOVERNING BOARD AND MANAGEMENT DEVELOP PROGRAMS WHICH ENHANCE THE CHARITABLE MISSION OF THE ORGANIZATION. DISBURSEMENT FOR GRANTS OR ASSISTANCE FOR THESE PROGRAMS ARE MADE IN ACCORDANCE WITH PRESCRIBED PROCEDURES AND ARE SUBJECT TO CONDITIONS ESTABLISHED BY THE ORGANIZATION'S GOVERNING BOARD AND MANAGEMENT, WHICH ARE DESIGNED TO ENSURE THAT INDIVIDUALS AND ORGANIZATIONS RECEIVING GRANTS OR ASSISTANCE ARE ADEQUATELY INVESTIGATED TO ENSURE THAT THEY ARE QUALIFIED RECIPIENTS.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DAVE KAPASKA DO
0	504214	0	500	0	151790	0	25849	0	17709	0	700062	0	0
KIM PEDERSON MD
292795	0	0	0	4397	0	17616	0	15940	0	330748	0	0	0
DON KOSIAK MD
414900	0	0	0	920	0	17616	0	6140	0	439576	0	0	0
JULIE N NORTON
351421	0	0	0	1001	0	17616	0	23562	0	393600	0	0	0
JUDY BLAUWET
315000	0	0	0	6080	0	12716	0	19512	0	353308	0	0	0
DAVID FLICEK
0	366573	0	500	0	114603	0	13475	0	20498	0	515649	0	0
STEVE PETERSEN
191130	0	0	0	1700	0	10143	0	20972	0	223945	0	0	0
PATRICIA JAGOE
189105	0	0	0	850	0	14039	0	20574	0	224568	0	0	0
CURT HOHMAN
269460	0	0	0	1132	0	17616	0	6796	0	295004	0	0	0
HAMID ABBASI MD
1114076	0	0	0	2850	0	17615	0	17972	0	1152513	0	0	0
BRIAN KNUTSON MD
1123325	0	0	0	2845	0	17616	0	20472	0	1164258	0	0	0
DANIEL TYNAN MD
1227478	0	0	0	7892	0	17616	0	18972	0	1271958	0	0	0
STEVEN CONDRON MD
1218816	0	0	0	2496	0	17616	0	22972	0	1261900	0	0	0
KELLY MCCAUL MD
1057802	0	0	0	3959	0	17616	0	7296	0	1086673	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 4A	PATRICIA JAGOE, FORMER KEY EMPLOYEE, RECEIVED SEVERANCE PAYMENTS FROM JULY 11, 2011 THROUGH OCTOBER 10, 2012. THE TOTAL COMPENSATION, PENSION, AND OTHER EMPLOYEE BENEFITS PAID TO HER DURING THAT TIME WERE $220,232.
PART III	SCHEDULE J, PART I LINE 3: THE PRESIDENT & CEO'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, AVERA HEALTH. AVERA MCKENNAN RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT & CEO USING THE METHODS DESCRIBED IN PART I, LINE 3.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Loan Table LoanTable

Field	Value	IRS element (for citing)
Name Person	HAMID ABBASI	NamePerson
Purpose Of Loan	PHYSICIAN RECRUITMENT	PurposeOfLoan
Loan From Organization	X	LoanFromOrganization
Original Principal	$100,000	OriginalPrincipalAmount
Balance Due	20833	BalanceDue
Default	0	Default
Approved By Board	1	ApprovedByBoard
Written Agreement	1	WrittenAgreement

Field	Value	IRS element (for citing)
Total Balance Due	20833	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
MICHAEL BENDER
BOARD MEMBER	213218	PROPERTY LEASE	0
SURGICAL INSTITUTE OF SD
ENTITY CONTROLLED BY BOARD MEMBER	1112746	TRAUMA CONTRACT AND ACUTE SURGICAL SERVICES CONTRACT	0
VICTORIA PETERSEN
FAMILY OF KEY EMPLOYEE	36345	EMPLOYEE COMPENSATION	0
JAMES HARTUNG
FAMILY OF FORMER KEY EMPLOYEE	42928	EMPLOYEE COMPENSATION	0
SIOUX FALLS CONSTRUCTION CO
BOARD MEMBER IS AN OFFICER OF THE ENTITY	5133665	CONSTRUCTION	0
STEVEN REICHELT
FAMILY OF BOARD MEMBER	24829	EMPLOYEE COMPENSATION	0
NEUROLOGY ASSOCIATES
BOARD MEMBER IS A GREATER THAN 5% PARTNER IN THE ENTITY	413560	ER CALL COVERAGE, RENTED SPACE, AND RENTED EQUIPMENT FROM MCKENNAN	0
VINCENTA ROSSING
FAMILY OF BOARD MEMBER	19126	EMPLOYEE COMPENSATION	0
WOODS FULLER SCHULTZ & SMITH PC
BOARD MEMBER IS AN OFFICER OF THE ENTITY	96387	LEGAL SERVICES	0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Description	ECARE EQUIPMENT	Description
Number Of Contributions	1	NumberOfContributions
Noncash Contribs Rptd F990	73149	NoncashContribsRptdF990
Method Of Determining Revenues	COST OF DONATED PROPERTY	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Number Of8283 Received	0	NumberOf8283Received
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
NEW PROGRAM SERVICES	FORM 990, PART III, LINE 2	AVERA MCKENNAN EXPANDED OUR PRIMARY CARE CLINICS BY OPENING 2 NEW AVERA MEDICAL GROUP MCGREEVY CLINICS IN SIOUX FALLS, SD. SPECIALTY CLINIC OFFERINGS ALSO EXPANDED WITH A NEW PEDIATRIC CLINIC AND THE ACQUISITION OF A COMPREHENSIVE BREAST CARE CLINIC. AVERA MCKENNAN ACQUIRED AN ONCOLOGY CLINIC AND INFUSION CENTER WHICH IS A STRATEGIC GAIN FOR OUR CANCER PROGRAM AND ALSO ESTABLISHES AVERA IN COMMUNITIES THAT HAVE OTHERWISE NOT HAD AN AVERA PRESENCE.
PROGRAM SERVICE STATEMENT	FORM 990, PART III, LINE 4A	MAJOR SERVICE LINES INCLUDE ONCOLOGY, SURGERY, ORTHOPEDICS, OBSTETRICS, PEDIATRICS, NEONATOLOGY, EMERGENCY AND TRAUMA, CRITICAL CARE INCLUDING EICU, RADIOLOGY AND DIAGNOSTIC IMAGING, PSYCHIATRY, PULMONARY, NEUROLOGY, CARDIOLOGY, AND GASTROENTEROLOGY. TRANSPLANT SERVICES INCLUDE SOLID ORGAN (KIDNEY AND PANCREAS) AND BONE MARROW TRANSPLANT. THE FOLLOWING ARE SPECIFIC EXEMPT PURPOSE ACHIEVEMENTS FOR AVERA MCKENNAN HOSPITAL: CHARITY AND UNCOMPENSATED CARE: AVERA MCKENNAN PROVIDES NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2012, SERVICES PROVIDED TO THOSE WHO ARE UNABLE TO PAY TOTALED $29,837,000, BASED ON CHARGES FOREGONE. ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME LEVELS. GENERALLY, INDIVIDUALS EARNING INCOME OF UP TO 400% OF THE FEDERAL POLICY INCOME GUIDELINES ARE ELIGIBLE FOR VARYING LEVELS OF DISCOUNTS, INCLUDING FULL DISCOUNTS FOR CERTAIN INCOME LEVELS. APPLICATION FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY AVERA MCKENNAN PATIENT REGISTRATION AREA OR BY CALLING AVERA MCKENNAN PATIENT FINANCIAL SERVICES. IN ADDITION TO CHARITY CARE, IN THE PAST FISCAL YEAR AVERA MCKENNAN PROVIDED $186,876 IN LODGING, TRANSPORTATION AND PRESCRIPTIONS TO THOSE IN NEED. ACCESSIBILITY TO HEALTH CARE: AVERA MCKENNAN MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY IT SERVES. IN 2012 AVERA MCKENNAN HAD 20,691 HOSPITAL DISCHARGES, 106,036 PATIENT DAYS AND 220,991 OUTPATIENT VISITS. AVERA MCKENNAN IS A VERIFIED LEVEL II TRAUMA CENTER AND WAS THE FIRST SUCH CENTER IN THE STATE OF SOUTH DAKOTA. AVERA MCKENNAN'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY WITH BOARD-CERTIFIED EMERGENCY SPECIALISTS AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. AVERA MCKENNAN HAD 26,200 EMERGENCY DEPARTMENT VISITS IN FY 2012. OPERATING BOTH FIXED WING AND HELICOPTER MEDICAL AIR TRANSPORTS, AVERA MCKENNAN'S FLIGHT TEAMS COVER A LARGE GEOGRAPHIC AREA PROVIDING STATE-OF-THE-ART AIR TRANSPORT SERVICES AND ACCESS TO CRITICAL CARE, WITH 1,328 FLIGHTS IN THE PAST YEAR. HEALTH CARE CLINIC: IN 1992, AVERA MCKENNAN ESTABLISHED A HEALTH CARE CLINIC TO PROVIDE FREE CARE FOR PEOPLE WHO ARE UNINSURED OR UNDERINSURED IN THE COMMUNITY. THE CLINIC IS MANAGED BY A REGISTERED NURSE AND STAFFED BY REGISTERED NURSES, TWO MIDLEVEL PROVIDERS, MEDICAL RESIDENTS, AND VOLUNTEER HEALTH CARE PROVIDERS. THE GOAL OF THE CLINIC IS TO PREVENT OR TREAT PATIENTS' MEDICAL CONDITIONS BEFORE THEY BECOME CATASTROPHIC. THE CLINIC AVERAGES 694 VISITS PER MONTH, PROVIDING PREVENTATIVE CARE, DIAGNOSIS AND TREATMENT OF ILLNESSES AND INJURIES, MEDICATION ASSISTANCE AND ASSISTANCE IN OBTAINING SPECIALIST CARE FOR PATIENTS WITH COMPLEX CASES. THE CLINIC ALSO SERVES TO TRAIN PHYSICIANS, NURSES AND OTHER HEALTH CARE STUDENTS. IT PROVIDES A FREE EVENING CLINIC ONE EVENING PER MONTH, STAFFED BY MEDICAL STUDENTS UNDER SUPERVISION OF PHYSICIANS. AVERA MCKENNAN IS THE ONLY HEALTH CARE ORGANIZATION TO PROVIDE FREE SERVICES SUCH AS THIS IN THE STATE OF SOUTH DAKOTA. THE CLINIC HAD 8,329 VISITS IN FISCAL YEAR 2012, AND WAS OPERATED AT AN ANNUAL COST OF $704,303. AVERA MCKENNAN PARTNERS WITH THE NOT-FOR-PROFIT DESTINY CLINIC BY PROVIDING FUNDING OF $13,000 PER YEAR TO PROVIDE FREE EVENING CLINIC SERVICES. RESIDENCY/HEALTH PROFESSIONS TRAINING AND INTERNSHIPS: IN 2012, AVERA MCKENNAN HAD 90 MEDICAL SCHOOL RESIDENTS IN TRAINING AT AVERA MCKENNAN IN INTERNAL MEDICINE, FAMILY PRACTICE, PSYCHIATRY, GERIATRICS AND TRANSITIONAL RESIDENCY PROGRAMS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE. OVER 800 STUDENTS IN NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, RADIOLOGY AND RESPIRATORY THERAPY ALSO COMPLETED ROTATIONS AT AVERA MCKENNAN. AVERA MCKENNAN HAS MANY JOINT AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION FOR BOTH CLINICAL AND EDUCATIONAL PROGRAMMING. IN NON-CLINICAL AREAS, AVERA MCKENNAN OFFERED 42 UNPAID INTERNSHIPS IN 2012 IN THE AREAS OF MARKETING, HUMAN RESOURCES, FOUNDATION, NETWORK OPERATIONS AND PROCESS EXCELLENCE, WORKING WITH APPROXIMATELY 17 INSTITUTIONS OF HIGHER EDUCATION. COMMUNITY EDUCATION: AVERA MCKENNAN IS A REGIONAL LEADER IN OFFERING EDUCATIONAL PROGRAMS FOR A VARIETY OF LEARNERS, LEADERS AND EMPLOYEES. UTILIZING ADVANCE TECHNOLOGY, MANY OF THESE PROGRAMS ARE PROVIDED ELECTRONICALLY THROUGHOUT THE TRI-STATE AREA. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS AT ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING AVERA MCKENNAN'S EDUCATION CENTER, A BROAD CROSS-SECTION OF CLASSES INVOLVING DIVERSE AUDIENCES ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR. -TO BE WELL FREE EDUCATION EVENTS WERE HELD ON TOPICS INCLUDING ORTHOPEDICS, CANCER, DIABETES, WEIGHT LOSS/HEALTHY EATING, MULTIPLE SCLEROSIS, ANXIETY AND ACUPUNCTURE. - FORUMS: THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE FRIDAY FORUMS, IN WHICH SCHOOL COUNSELORS AND THERAPISTS ARE INVITED TO PRESENTATIONS ON CHILDREN'S MENTAL HEALTH TOPICS SUCH AS CONFLICT CYCLES, REACTIVE ATTACHMENT DISORDER, DEPRESSION AND BIPOLAR DISORDER IN CHILDREN, AND TEEN SUBSTANCE USE, ABUSE AND ADDICTION. THESE SESSIONS, HELD NINE TIMES EACH YEAR, ARE ATTENDED IN PERSON BY APPROXIMATELY 85. THROUGHOUT 2012, VIDEOS OF THESE PRESENTATIONS WERE VIEWED 396 TIMES ONLINE. -THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE MONTHLY EDUCATIONAL SESSIONS ON VARIOUS TOPICS FOLLOWED BY DISCUSSION FOR ADULTS WHO HAVE BEEN IMPACTED BY A LOVED ONE'S MENTAL ILLNESS. TOPICS HAVE INCLUDED GRIEF AND LOSS, ANXIETY, AND PARENTING STRATEGIES FOR MANAGING CHALLENGING BEHAVIORS. - WOMEN'S & CHILDREN'S SERVICES: AVERA MCKENNAN'S WOMEN'S & CHILDREN'S SERVICES OFFER A NUMBER OF PARENTING AND COMMUNITY EDUCATION OPPORTUNITIES, FOR FREE OR AT A MINIMAL COST. IN FISCAL YEAR 2012, 166 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 1,053 ATTENDEES. A TOTAL OF 36 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 307 ATTENDEES. A TOTAL OF 135 CAR SEATS WERE ISSUED THROUGH PROJECT 8, SOUTH DAKOTA GOVERNOR'S CHILD SEAT PROGRAM WITH TRAINING ON THEIR CORRECT USE. FREE BURN EDUCATION WAS PROVIDED TO 2,516 STUDENTS DURING PRESENTATIONS IN SCHOOLS. -DAYCARE TRAINING: FREE OF CHARGE, AVERA MCKENNAN OFFERS FOUR IN-SERVICE TRAINING SESSIONS PER MONTH TO DAYCARE PROVIDERS THROUGH THE YWCA, WITH A TOTAL OF 36 SCHEDULED ANNUALLY, AND ADDITIONAL SESSIONS FOR REQUESTED TOPICS. SUPPORT GROUPS: AVERA MCKENNAN OFFERS APPROXIMATELY 10 FREE SUPPORT GROUPS. THEY RANGE IN TOPIC FROM CANCER TO LIVER DISEASE, DIABETES, BONE MARROW TRANSPLANT, STROKE AND GRIEF AND LOSS. THE ORGANIZATION PROVIDES FREE MEETING SPACE AS WELL AS SPEAKERS AND LEADERS. INFORMATION AND ASSISTANCE: AVERA MCKENNAN OPERATES A 24-HOUR MEDICAL CALL CENTER, THROUGH WHICH PATIENTS HAVE ACCESS TO THE ASK-A-NURSE PROGRAM. PATIENTS CAN CALL A TOLL-FREE NUMBER AND TALK PERSONALLY WITH A REGISTERED NURSE TO ASK HEALTH QUESTIONS OR RECEIVE GENERAL HEALTH INFORMATION. IN 2012, THE MEDICAL CALL CENTER HANDLED 99,000 CALLS. AVERA MCKENNAN'S WEB SITE ALSO PROVIDES AN EXTENSIVE HEALTH LIBRARY THAT CONSUMERS CAN ACCESS FREE OF CHARGE. INTERPRETER SERVICE: AVERA MCKENNAN EMPLOYS TWO FULL-TIME SPANISH INTERPRETERS IN-HOUSE, AND THEIR SERVICES ARE OFFERED TO PATIENTS FREE OF CHARGE. IN ADDITION, IN COOPERATION WITH EXTERNAL AGENCIES, AVERA MCKENNAN IS ABLE TO HANDLE 99 DIFFERENT LANGUAGES AND DIALECTS. AVERA MCKENNAN CONTRACTS FOR AN INBOUND CALL-IN SERVICE FOR SPANISH SPEAKING INDIVIDUALS. THIS IS AVAILABLE AT THE MAIN HOSPITAL SWITCHBOARD, AS WELL AS AVERA MCGREEVY CLINIC AND AVERA WOMEN'S CLINIC. ALL THE ABOVE SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. PRENATAL AND DELIVERY CARE: BECAUSE EARLY AND REGULAR PRENATAL CARE IS IMPORTANT TO PREVENT PREMATURE BIRTH, AVERA MCKENNAN COLLABORATES IN A COMMUNITY EFFORT TO PROVIDE OBSTETRICS CARE FOR WOMEN WHO DO NOT QUALIFY FOR MEDICAID, BUT CANNOT AFFORD HEALTH INSURANCE. THE PROGRAM OFFERS PRENATAL CARE, AND HOSPITAL LABOR AND DELIVERY FOR A LOW FEE OF $1,000. WOMEN RECEIVE CARE WHETHER THEY CAN COVER ANY OR ALL OF THE FEE. CARE IS PROVIDED PRIMARILY BY FIRST-YEAR FAMILY PRACTICE RESIDENTS, SUPERVISED BY EXPERIENCED PHYSICIANS. THROUGH THIS PROGRAM IN 2012, AVERA MCKENNAN ASSISTED WITH 81 BIRTHS AND PROVIDED 823 PRENATAL AND POST-PARTUM VISITS.
		TRANSPORT TO TRANSPLANT: AVERA MCKENNAN DEVELOPED THE TRANSPORT TO TRANSPLANT PROJECT, WHICH REMOVES TRANSPORTATION BARRIERS FOR PATIENTS FROM RURAL AREAS WHICH MAY PREVENT THEM FROM COMPLETING THE EVALUATION AND TESTING NEEDED FOR KIDNEY AND/OR PANCREAS TRANSPLANT. A VAN FUNDED THROUGH A GRANT FROM THE AVERA MCKENNAN FOUNDATION IS USED TO TRANSPORT PATIENTS WHO DEMONSTRATE A FINANCIAL NEED. PATIENTS ARE BROUGHT TO THE AVERA TRANSPLANT INSTITUTE FOR A CONDENSED MULTI-DAY EVALUATION WITH ALL TESTING AND VISITS COMPLETED IN LESS THAN ONE WEEK. ULTIMATELY, THE PROJECT RESULTS IN IMPROVED MORBIDITY AND MORTALITY, AS KIDNEY TRANSPLANT DOUBLES PATIENT SURVIVAL AS COMPARED TO REMAINING ON DIALYSIS. AVERA FAMILY WELLNESS: THIS PROGRAM COMBINES POSITIVE ACTIVITIES LIKE VIOLIN LESSONS WITH FAMILY COACHING AT NO CHARGE FOR CHILDREN IN EARLY CHILDHOOD PROGRAMS IN THE SIOUX FALLS SCHOOL DISTRICT. THE GOAL IS TO PREVENT OR LESSEN THE EFFECTS OF BEHAVIORAL HEALTH CONDITIONS ON CHILDREN AND FAMILIES BY FOSTERING A POSITIVE ENVIRONMENT. APPROXIMATELY 200 STUDENTS ARE ENROLLED. THE WALSH FAMILY VILLAGE: THIS HOSPITALITY HOUSE COMPLEX ADJACENT TO THE AVERA MCKENNAN CAMPUS PROVIDES A HOME AWAY FROM HOME FOR PATIENTS AND THEIR FAMILIES WHO COME FOR CARE AT AVERA MCKENNAN FROM OUTSIDE OF SIOUX FALLS. THE PROJECT WAS FUNDED BY DONATIONS AND IS OPERATED BY AVERA MCKENNAN. ELEVEN GUEST ROOMS ARE AVAILABLE. AVERA MCKENNAN ALSO DONATES USE OF A BUILDING IN THE COMPLEX FOR A RONALD MCDONALD HOUSE FOR FAMILIES OF PEDIATRIC PATIENTS. IF THEY CAN AFFORD IT, GUESTS ARE CHARGED A LOW FEE OF $46.50 PER NIGHT. IF THEY CANNOT AFFORD THE EXPENSE, THE COST OF THE ROOM IS WAIVED. EMPLOYEES REGULARLY DONATE NON-PERISHABLE FOOD ITEMS TO STOCK A FOOD PANTRY FOR GUESTS. IN 2012 THE WALSH FAMILY VILLAGE SERVED 7,018 GUESTS, STAYING IN 4,026 NIGHTLY ROOMS - A 92 PERCENT OCCUPANCY. AVERA MCKENNAN PROVIDES A SUBSIDY OF APPROXIMATELY $260,000 PER YEAR TO OPERATE THE HOSPITAL COMPLEX. PREVENTION AND SUPPORT OF SUBSTANCE USE DISORDER: AVERA MCKENNAN IS A PARTNER WITH FACE IT TOGETHER SIOUX FALLS, A NONPROFIT ORGANIZATION WHICH SERVES AS THE LOCAL FACE AND VOICE FOR RECOVERY FROM ADDICTION THROUGH ITS RECOVERY SUPPORT SERVICES, ADVOCACY AND AWARENESS PROGRAMS. AVERA HAS BEEN A PARTNER WITH FACE IT TOGETHER SINCE ITS INCEPTION, AND IN A RECENT AWARENESS CAMPAIGN. IN 2012, AVERA MCKENNAN PROVIDED $50,000 IN FUNDING TOWARD THIS EFFORT. SUPPORT OF INDIAN RESERVATIONS: IN 2012, AVERA MCKENNAN DELIVERED ONE TRUCKLOAD OF EXCESS MEDICAL EQUIPMENT, FURNITURE AND SUPPLIES TO INDIAN RESERVATIONS IN SOUTH DAKOTA, AND SUPPORTED A CHRISTMAS PARTY FOR CHILDREN. COMMUNITY CONNECTIONS: AVERA MCKENNAN REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT EASTERN SOUTH DAKOTA, SOUTHWESTERN MINNESOTA AND NORTHWEST IOWA THROUGH HOME TOWN CONNECTIONS. PROVIDING A CRITICAL FEEDBACK LINK TO LOCAL REFERRING DOCTORS, THIS PROGRAM COMPLETES THE COMMUNICATIONS LINKS NECESSARY TO KEEP LOCAL HEALTH CARE PROVIDERS CURRENT ON THE TREATMENT OF THEIR PATIENTS AT AVERA MCKENNAN. SUPPORT OF THE ARTS AND CULTURAL LIFE: AVERA MCKENNAN HOSTS SIOUX FALLS' ONLY INDOOR SCULPTUREWALK, AN EXTENSION OF THE COMMUNITY'S DOWNTOWN SCULPTUREWALK. ARTISTS DONATE SCULPTURES FOR ONE YEAR, WHICH ARE PLACED AT LOCATIONS THROUGHOUT AVERA MCKENNAN'S CAMPUS, IN BUILDINGS CONNECTED BY SKYWALKS. BROCHURES CONTAIN A MAP, AND VISITORS WHO FOLLOW THE ROUTE SUGGESTED WALK APPROXIMATELY 1 MILE, MAKING THIS A HEALTHY AS WELL AS A CULTURAL JOURNEY. DIABETES PROGRAMMING: AVERA PARTICIPATES IN A COLLABORATIVE PROJECT WITH SIOUX FALLS PUBLIC SCHOOLS AND THE SOUTH DAKOTA BOARD OF NURSING TO IMPLEMENT ECONSULT SERVICES WITH DIABETIC EDUCATION SPECIALISTS MONITORING MEDICATIONS AND THE HEALTH OF CHILDREN WITH DIABETES IN THE SCHOOL SETTING. AVERA MCKENNAN DIABETES EDUCATORS PROVIDED CLASSES AND ONE-ON-ONE CONSULTATIONS AT A LOSS OF $648,744 IN THE PAST FISCAL YEAR. COMMUNITY BENEFITS: AVERA MCKENNAN PROVIDES ADDITIONAL COMMUNITY BENEFITS INCLUDING: SUPPORT OF YOUTH PROGRAMS; HOMELESS PROGRAMS; COMMUNITY ARTS PROGRAMMING; HEALTH PREVENTION; AWARENESS AND EDUCATION ABOUT CANCER, HEART DISEASE AND OTHER CONDITIONS; AND SUPPORT OF THE SIOUX EMPIRE UNITED WAY AND OTHER SERVICES IN THE REGION. DONATIONS TOWARD THESE EFFORTS TOTALED $1,858,000 IN 2012. PRESCHOOL VISION AND HEARING SCREENING: AVERA MCKENNAN PROVIDED FREE SCREENING FOR 347 PRESCHOOL CHILDREN IN FISCAL YEAR 2012.
PROGRAM SERVICE STATEMENT	FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICES:	AMONG SERVICES OFFERED BY RURAL HOSPITALS ARE RADIOLOGY AND IMAGING, COLONOSCOPY AND ENDOSCOPY, THERAPY AND REHABILITATION, 24-HOUR EMERGENCY CARE, CHEMOTHERAPY, ORTHOPEDICS, CARDIOVASCULAR TESTING AND CARE, OBSTETRICS, SURGERY, AND DIALYSIS. CHARITY AND UNCOMPENSATED CARE: AS PART OF AVERA MCKENNAN, THESE FACILITIES PROVIDE NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2012, CHARITY AND UNCOMPENSATED CARE PROVIDED BY RURAL HOSPITALS TOTALED $539,000. ACCESSIBILITY TO HEALTH CARE: AVERA MCKENNAN REGIONAL HOSPITALS MAKE MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY THEY SERVE REGARDLESS OF A PATIENT'S ABILITY TO PAY. IN 2012 RURAL HOSPITALS HAD 1,880 DISCHARGES, 7,904 PATIENT DAYS AND 57,780 OUTPATIENT VISITS. EACH OF THE HOSPITALS PROVIDES 24-HOUR EMERGENCY CARE WITH EEMERGENCY SERVICES THROUGH AVERA MCKENNAN. EICU SERVICES ARE ALSO AVAILABLE AT THESE HOSPITALS, PROVIDING ACCESS TO CRITICAL CARE MEDICINE NEAR HOME AND LESSENING THE NEED FOR TRANSPORT. THERE IS NO ADDITIONAL BILLING TO PATIENTS. TELEMEDICINE CONSULTS ARE ALSO OFFERED AT RURAL LOCATIONS IN A NUMBER OF MEDICAL SPECIALTIES.
PROGRAM SERVICE STATEMENT	FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICES:	CLINICS PROVIDE PRIMARY CARE AND URGENT CARE, AND AMONG SPECIALITIES ARE CARDIOLOGY; DERMATOLOGY; ENDOCRINOLOGY; GASTROENTEROLOGY; HEMATOLOGY; HEPATOLOGY; INFECTIOUS DISEASE; INTERNAL MEDICINE; NEONATOLOGY; NEPHROLOGY; NEUROLOGY AND NEUROSURGERY; OB/GYN; ONCOLOGY; OPHTHALMOLOGY; ORTHOPEDICS; PAIN MANAGEMENT; PEDIATRICS; PSYCHIATRY; PULMONOLOGY; SPORTS MEDICINE; SURGERY; AND VASCULAR SERVICES. CHARITY AND UNCOMPENSATED CARE: AS PART OF AVERA MCKENNAN, CLINICS PROVIDE NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2012, CHARITY AND UNCOMPENSATED CARE PROVIDED BY CLINICS TOTALED $1,079,886. ACCESSIBILITY TO HEALTH CARE: IN ADDITION TO REGULAR CLINIC HOURS, AVERA MCGREEVY CLINIC PROVIDES URGENT CARE, SEEING PATIENTS ON A WALK-IN BASIS AT TWO LOCATIONS DURING THE EVENING HOURS ON WEEKDAYS, AND THROUGHOUT THE DAYTIME HOURS ON SATURDAYS AND SUNDAYS. THIS PROVIDES GREATER ACCESSIBILITY WITHOUT HAVING TO RELY ON EMERGENCY ROOM CARE. IN ADDITION, THROUGH OUR CURAQUICK CLINICS, AVERA OFFERS CONVENIENT, AFFORDABLE CLINIC CARE IN LOCAL HYVEE PHARMACIES. IN 2012, AVERA DONATED APPROXIMATELY 40 CURAQUICK AVERA CARDS, GOOD FOR ONE FREE VISIT, TO STUDENTS OF SIOUX FALLS CATHOLIC SCHOOLS AND YWCA DAYCARE, EACH VALUED AT $59. HEALTH SCREENINGS: AVERA MCKENNAN CLINICS OFFERED A FREE HEPATITIS C SCREENING, SERVING 610 PERSONS AND VARICOSE VEIN SCREENING SERVING 50.
	FORM 990, PART VI, SECTION A, LINE 2	GENE JONES JR., CINDY WALSH, AND FRED THURMAN - BUSINESS RELATIONSHIP TOM DEMPSTER AND FRED THURMAN - BUSINESS RELATIONSHIP
	FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE ORGANIZATION IS AVERA HEALTH, A NONPROFIT CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF SOUTH DAKOTA AND EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.
	FORM 990, PART VI, SECTION A, LINE 7A	AVERA HEALTH, AS THE SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, ALL MEMBERS OF THE BOARD OF DIRECTORS.
	FORM 990, PART VI, SECTION A, LINE 7B	AVERA HEALTH HAS THE FOLLOWING RIGHTS AS THE MEMBER: 1) TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE STATEMENTS OF PHILOSOPHY, MISSION AND VALUES OF CORPORATION; 2) TO INITIATE THE ADOPTION, AMENDMENT OR REPEAL OF ANY PROVISION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CORPORATION, AND TO GIVE FINAL APPROVAL OF ANY SUCH ACTION WITH RESPECT THERETO; 3) TO APPROVE AND ACT UPON THE ALIENATION OF REAL PROPERTY AND PRECIOUS ARTIFACTS UNDER THE CANONICAL STEWARDSHIP OF THE SISTERS OF THE PRESENTATION OF THE BLESSED VIRGIN MARY OF ABERDEEN, SOUTH DAKOTA ("PRESENTATION SISTERS") OR THE BENEDICTINE SISTERS OF SACRED HEART MONASTERY ("BENEDICTINE SISTERS"), PURSUANT TO THE POLICIES ESTABLISHED BY THE MEMBER; 4) TO APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION, OR THE DIVESTITURE OF A SPONSORED WORK OR MINISTRY ASSOCIATED WITH THE CORPORATION; 5) TO APPROVE THE CREATION OF NEW SPONSORED WORKS OR MINISTRIES TO BE CONDUCTED BY OR UNDER THE AUTHORITY OF THE CORPORATION; 6) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE BOARD OF DIRECTORS OF THE CORPORATION. 7) TO APPOINT AND/OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION. 8) TO APPROVE OPERATING/CAPITAL BUDGETS AND STRATEGIC PLANS OF THE CORPORATION. 9) TO APPROVE EXPENDITURES OUTSIDE OF OPERATING AND CAPITAL BUDGETS EXCEEDING DEFINED THRESHOLDS ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 10) TO APPROVE ACQUISITIONS, SALES AND LEASES, ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 11) TO ESTABLISH AND MAINTAIN EMPLOYEE BENEFIT PROGRAMS. 12) TO ESTABLISH AND MAINTAIN INSURANCE PROGRAMS. 13) TO APPROVE MAJOR COMMUNITY FUND DRIVES. 14) TO APPROVE THE APPOINTMENT OF AUDITORS. 15) TO ADOPT POLICIES DESIGNED TO EFFECTUATE THE RESERVED POWERS OF THE MEMBER.
	FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND ASSISTANT VP OF FINANCIAL REPORTING. AFTER THE INITIAL REVIEW, A DRAFT IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW. THE APPROVED RETURN IS PROVIDED TO THE FULL BOARD PRIOR TO FILING.
	FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. AT EACH BOARD MEETING, A REQUEST IS MADE FOR ALL BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST PERTAINING TO ANY ITEM LISTED ON THE AGENDA OR PERTAINING TO ANY POTENTIAL ITEM THAT COULD BE DISCUSSED DURING THE COURSE OF THE MEETING. THE DECLARATION OF CONFLICT OF INTEREST IS RECORDED IN THE MEETING MINUTES. THE BOARD MAKES A DETERMINATION OF WHETHER THERE IS A CONFLICT OF INTEREST AND IF SO, IMPLEMENTS THE PROCEDURE FOR EVALUATING THE ISSUE OR TRANSACTION INVOLVED. THE BOARD MEMBER OR OFFICER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND DIRECTORS. THE INFORMATION IS MAINTAINED IN A DATABASE AND A REPORT IS PROVIDED TO THE BOARD.
	FORM 990, PART VI, SECTION B, LINE 15B	THE CEO IS COMPENSATED BY AVERA HEALTH SYSTEM. ANNUALLY THE COMPENSATION COMMITTEE OF AVERA HEALTH, WHICH IS COMPRISED OF SIX (6) SYSTEM MEMBERS APPOINTED BY THE RELIGIOUS ORDERS, MEETS WITH AN INDEPENDENT CONSULTANT REGARDING FAIR MARKET VALUE FOR COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE APPROVES ALL SALARIES BASED ON COMPARABLE DATA AND DOCUMENTS THE BASIS FOR THEIR DECISION IN MEETING MINUTES. THE CFO AND KEY EMPLOYEES ARE COMPENSATED BY AVERA MCKENNAN. ANNUALLY, THE COMPENSATION COMMITTEE OF AVERA MCKENNAN, WHICH IS COMPRISED OF BOARD MEMBERS, MEETS TO REVIEW THE COMPENSATION OF EXECUTIVES AND PHYSICIANS. AVERA MCKENNAN COMPARES ITS COMPENSATION PLAN TO OTHER HEALTHCARE ORGANIZATIONS SIMILAR IN SIZE AND COMPLEXITY TO AVERA MCKENNAN ON A NATIONAL BASIS TO ENSURE COMPENSATION IS COMPARABLE. AVERA MCKENNAN UTILIZES MULTIPLE SALARY SURVEYS AND AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE A MARKET ANALYSIS FOR EACH EXECUTIVE'S SUGGESTED PAY OR PAY RANGE. INDIVIDUAL SALARIES REFLECT RELATED EDUCATION AND EXPERIENCE, AS WELL AS THE SCOPE OF THE DUTIES TO ASSURE AMOUNTS PAID ARE REASONABLE.
	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE AVAILABLE TO THE GENERAL PUBLIC.
	FORM 990, PART VI, SECTION B, LINE 16B:	THERE IS NO WRITTEN POLICY OR PROCEDURE REQUIRING THE ORGANIZATION TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS. IN THE EVENT OF ANY SUCH PROPOSED TRANSACTION THE BOARD, OR A COMMITTEE WITH DELEGATED AUTHORITY, REVIEWS ALL MATERIALS, VALUATIONS, AND OPERATIONAL ASPECTS FOR ANY PROPOSED TRANSACTION. SUCH TRANSACTION WOULD BE EVALUATED IN ACCORDANCE WITH THE EXEMPT STATUS OF THE ORGANIZATION AND ITS APPLICABLE PURPOSES. ANY TRANSACTION ALSO MUST BE APPROVED BY THE BOARD AND THE MEMBER.
	FORM 990, PART VII, SECTION A, COLUMN (B)	IN ADDITION TO THE AVERAGE OF 2 HOURS PER WEEK THAT SISTER JOAN REICHELT DEDICATES AS A BOARD MEMBER OF AVERA MCKENNAN, SISTER JOAN REICHELT DEDICATES AN AVERAGE OF AN ADDITIONAL 1.3 HOURS PER WEEK AS A BOARD MEMBER TO AVERA MARSHALL AND 2.5 HOURS PER WEEK AS A BOARD MEMBER TO AVERA QUEEN OF PEACE, RELATED ORGANIZATIONS.
	FORM 990, PART X, LINE 20:	THE ISSUE PRICE INCLUDES THE FILING ORGANIZATION'S SHARE OF THE ENTIRE BOND ISSUE, WHICH WAS ISSUED TO AVERA HEALTH ON BEHALF OF THE AVERA OBLIGATED GROUP. THE AVERA OBLIGATED GROUP CONSISTS OF AVERA HEALTH, AVERA MCKENNAN, AVERA ST. LUKE'S, AVERA QUEEN OF PEACE, AVERA SACRED HEART, AND AVERA MARSHALL. IN ACCORDANCE WITH IRS INSTRUCTIONS, INFORMATION RELATED TO THE TAX EXEMPT BOND REPORTING IS BEING REPORTED ON AVERA HEALTH'S TAX RETURN (EIN 46-0422673).
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -6,031,404. EQUITY TRANSFERS, NET 755,783. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -5,258,882. LOSS ON RETIREMENT OF DEBT -1,419,188. OTHER CHANGES IN NET ASSETS 66,412. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP DESIGNATED AS HEDGE -883,328. GAIN ON ACQUISITION 2,724,749. BOOK TAX DIFFERENCE - EQUITY METHOD -15,814. BOOK TAX DIFFERENCE - CONSOLIDATED -821,603. TOTAL TO FORM 990, PART XI, LINE 5: -10,883,275.
	FORM 990, PART XII, LINE 2C:	THE AUDIT COMMITTEE OF AVERA HEALTH, THE PARENT ORGANIZATION OF AVERA MCKENNAN, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA MCKENNAN. ALSO, THE FINANCE COMMITTEE AT AVERA MCKENNAN TAKES RESPONSIBILITY FOR REVIEWING THE AUDITED FINANCIAL STATEMENTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
SIOUX FALLS HOSPITAL MANAGMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	562141521	MANAGEMENT COMPANY OF HEART HOSPITAL	NC	0	6042850	WEST 69TH STREET LLC
WEST 69TH STREET LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045		HOLDING COMPANY	SD	0	6042850	AVERA MCKENNAN
ALUMEND LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045		RESEARCH AND DEVELOPMENT	SD	0	1621857	AVERA MCKENNAN

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
AVERA ST ANTHONY'S HOSPITAL
300 N 2ND STREET	ONEILL	NE	68763	470463911	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA HOLY FAMILY
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	420680370	HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	421317452	FUNDRAISING	IA	501(C)(3)	LINE 9	AVERA HOLY FAMILY	0
ST BENEDICT HEALTH CENTER
401 WEST GLYNN DRIVE	PARKSTON	SD	57366	460226738	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
ST BENEDICT HEALTH CENTER FOUNDATION
WEST GLYNN DRIVE PO BOX B	PARKSTON	SD	57366	460458725	SUPPORT HEALTH RELATED SERVICES	SD	501(C)(3)	LINE 11A, I	ST BENEDICT HEALTH CENTER	0
AVERA HEALTH
3900 WEST AVERA DRIVE STE 300	SIOUX FALLS	SD	57108	460422673	PROMOTION OF HEALTH	SD	501(C)(3)	LINE 9		0	N/A
AVERA QUEEN OF PEACE
525 NORTH FOSTER	MITCHELL	SD	57301	460224604	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
SACRED HEART HEALTH SERVICES
501 SUMMIT STREET	YANKTON	SD	57078	460225483	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
SACRED HEART RURAL HEALTH CLINICS
501 SUMMIT STREET	YANKTON	SD	57078	460423930	CLINIC SERVICES	SD	501(C)(3)	LINE 3	SACRED HEART HEALTH SERVICES	0
HEALTH MANAGEMENT SERVICES
501 SUMMIT STREET	YANKTON	SD	57078	460399291	ADULT DAYCARE AND HOMEMAKING SERVICES	SD	501(C)(3)	LINE 9	SACRED HEART HEALTH SERVICES	0
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
1000 W 4TH STREET SUITE 9	YANKTON	SD	57078	460337013	HEALTHCARE EDUCATION	SD	501(C)(3)	LINE 9	SACRED HEART HEALTH SERVICES	0
AVERA ST LUKE'S
305 SOUTH STATE STREET	ABERDEEN	SD	57401	460224598	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA WORKERS' COMPENSATION TRUST
3900 WEST AVERA DRIVE	SIOUX FALLS	SD	57108	460407148	ECONOMICAL COVERAGE OF WORKERS' COMPENSATION CLAIMS	SD	501(C)(3)	LINE 11B, II	AVERA HEALTH	0
AVERA MARSHALL
300 S BRUCE STREET	MARSHALL	MN	56258	410919153	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA MARSHALL FOUNDATION
300 SOUTH BRUCE STREET	MARSHALL	MN	56258	411784801	FUNDRAISING	MN	501(C)(3)	LINE 7	AVERA MARSHALL	0

Form990 Schedule R Part III Form990ScheduleRPartIII (12 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Direct Controlling Entity NADirectControllingEntityNA
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	460488198	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA MCKENNAN	RELATED	616297	5320309	1	$153,051	1	0.78630
MIDWEST REGIONAL IMAGING SERVICES LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	470874983	HEALTH CARE - MEDICAL IMAGING	SD	AVERA MCKENNAN	RELATED	1937357		1		1	0.51000
HOME MEDICAL EQUIPMENT OF PIERRE LLC
329 E DAKOTA	PIERRE	SD	57501	460444002	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA MCKENNAN	RELATED	67720	219764	0	$19,465	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	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	24792	84435	1	$6,843	1	0.39330
AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC
PO BOX 5045	SIOUX FALLS	SD	57117	201686097	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	13560	139412	1	$3,690	1	0.39330
AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC
38 19TH ST SW	SIOUX CENTER	IA	51250	753203100	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	32762	121478	1	$10,225	1	0.39330
AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC
1104 EAST COLLEGE DRIVE	MARSHALL	MN	56258	205271924	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	78257	294807	1	$22,585	1	0.39330
Q&M PROPERTIES LLC
525 NORTH FOSTER	MITCHELL	SD	57301	731652049	MEDICAL CLINIC BUILDING	SD	AVERA QUEEN OF PEACE	RELATED	-477	411081	0		0	0.50000
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA ST	ABERDEEN	SD	57401	460461429	SURGICAL ASSOCIATES	SD									N/A
AVERA HME OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVENUE 102	SIOUX FALLS	SD	57117	800619999	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	3129	99663	1	$1,538	1	0.39330
HEART HOSPITAL OF SOUTH DAKOTA LLC
4500 W 69TH STREET	SIOUX FALLS	SD	57108	562143771	HEALTHCARE SERVICES	SD	AVERA MCKENNAN	RELATED	9535430	27665905	0		0	0.66670
BROOKINGS HEALTH SYSTEM - AVERA HME LLC
101 22ND AVE SUITE 101	BROOKINGS	SD	57006	453204123	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	AVERA HOME MEDICAL EQUIPMENT LLC	RELATED	-19198	180814	1	-$15,660	1	0.39330

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity
ACCOUNTS MANAGEMENT INC
5132 S CLIFF AVE SUITE 101	SIOUX FALLS	SD	57108	460373021	COLLECTION AGENCY	SD	N/A	C
AVERA HEALTH PLANS INC
3900 WEST AVERA DRIVE SUITE 101	SIOUX FALLS	SD	57108	460451539	HEALTH FINANCING AND HEALTH PLAN ADMINISTRATION	SD	N/A	C
AVERA PROPERTY INSURANCE INC
610 W 23RD ST STE 1 PO BOX 38	YANKTON	SD	57078	460463155	INSURANCE	SD	N/A	C
VALLEY HEALTH SERVICES
501 SUMMIT STREET	YANKTON	SD	57078	460357149	MEDICAL EQUIPMENT	SD	N/A	C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
AVERA HOME MEDICAL EQUIPMENT LLC
A	306876	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
K	136751	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
Q	372800	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
Q	4291651	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
R	118464	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
R	5135447	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
R	1099266	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
C	280500	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
C	591360	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
C	8622758	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
K	1286831	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
Q	756833	INTERCOMPANY DETAIL FROM GL

Form990 Schedule R Part VII Form990ScheduleRPartVII

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