2013-05-15T13:18:05-05:00 2012-06-30 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2011-07-01 460224743 AVERA MCKENNAN AVER 6053228000 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS SD 571175045 DR DAVID KAPASKA 6053228000 2013-05-13 1 KIM HUNWARDSEN CPA P00484560 6122536500 2013-05-13 2011 2016-02-24 21:20:13Z DR DAVID KAPASKA 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS SD 571175045 720347059 0 0928 X WWW.AVERAMCKENNAN.ORG X 1911 SD PROMOTION OF HEALTH 20 11 6573 1187 6961467 1722010 7931949 2006604 662236185 710238566 5052503 5478842 1840244 1681944 677060881 719405956 4118418 3588944 0 0 338604378 371268910 61855 67066 797434 285920426 307380219 628705077 682305139 48355804 37100817 762444106 800980977 336399684 348719013 426044422 452261964 X 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. 1 0 325133306 3516681 462472584 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. 39060730 35761 47714386 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. 184116649 35750 154012920 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. 30541087 750 46929942 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. 30541087 750 46929942 578851772 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 0 0 1 408 0 1 6573 1 1 1 0 0 0 0 0 0 0 0 0 X 20 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 X JULIE NORTON 6053228000 1325 S CLIFF AVE SIOUX FALLS SD 571175045 X TOM DEMPSTER 2.00 X X 0 0 0 DAVE ROZENBOOM 2.00 X X 0 0 0 DAVE KAPASKA DO 40.00 X X 0 656504 42862 MICHAEL BENDER 2.00 X 0 0 0 SISTER JANICE KLEIN 2.00 X 0 0 0 GENE JONES JR 2.00 X 0 0 0 MITCHELL JOHNSON DO 2.00 X 0 0 0 SISTER KATHRYN EASLEY 2.00 X 0 0 0 KIM PEDERSON MD 40.00 X 297192 0 32850 SISTER JOAN REICHELT 2.00 X 0 0 0 BRAD THAEMERT MD 2.00 X 0 0 0 FRED THURMAN 2.00 X 0 0 0 DAVID FLECK 2.00 X 0 0 0 JAMES WIEDERRICH 2.00 X 0 0 0 BILL ROSSING MD 2.00 X 0 0 0 CINDY WALSH 2.00 X 0 0 0 DAVID CHICOINE 2.00 X 0 0 0 SISTER CANDYCE CHRYSTAL 2.00 X 0 0 0 HUGH VENRICK 2.00 X 0 0 0 DON KOSIAK MD 40.00 X 415820 0 23049 JULIE N NORTON 40.00 X 352422 0 40472 JUDY BLAUWET 40.00 X 321080 0 31522 DAVID FLICEK 40.00 X 0 481676 33447 STEVE PETERSEN 40.00 X 192830 0 30409 PATRICIA JAGOE 40.00 X 189955 0 33907 CURT HOHMAN 40.00 X 270592 0 24125 HAMID ABBASI MD 40.00 X 1116926 0 34882 BRIAN KNUTSON MD 40.00 X 1126170 0 37382 DANIEL TYNAN MD 40.00 X 1235370 0 35882 STEVEN CONDRON MD 40.00 X 1221312 0 39882 KELLY MCCAUL MD 40.00 X 1061761 0 24625 7801430 1138180 465296 483 0 1 0 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 74 45986 1107700 148815 704103 73149 2006604 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 5139297 5119832 19465 710238566 130715 130715 1015464 941103 74361 74361 74361 5319453 28674 0 0 5319453 28674 5348127 5348127 INTEREST INCOME 900099 891266 891266 COMMERCIAL TESTING 621500 698071 698071 MANAGEMENT SERVICES 541610 18246 18246 1607583 719405956 704884682 6961467 5553203 3463944 3463944 125000 125000 2319959 1019669 1300290 296903173 271997589 24533061 372523 16668374 14864366 1779528 24480 36532443 32387878 4088632 55933 18844961 16770516 2047908 26537 167179 167179 641500 309170 332330 66946 13871 53075 35343 35343 67066 67066 88765546 53011896 35748783 4867 3617795 414944 3184864 17987 9879677 5110756 4582101 186820 7747684 850843 6896841 20090967 13921575 6144890 24502 3279993 2635776 638187 6030 1982068 1737865 243572 631 8103423 7862250 241173 34620097 28252771 6362271 5055 1064988 1055402 9586 MEDICAL SUPPLIES 100661292 100237100 422657 1535 BAD DEBT EXPENSE 18283341 18283341 EQUIPMENT LEASE AND REN 3766383 2901311 865072 UBI TAX 431759 431759 4174238 1025001 3145769 3468 682305139 578851772 102655933 797434 26868405 28110750 3360173 2439599 85293914 92528140 120833 20833 3431202 3360181 12517902 14389349 5340257 8098767 661320856 317713194 335141000 343607662 23658088 8322781 202453890 207116305 6876999 12187088 42209593 44273450 15171850 36526072 762444106 800980977 66443712 65431052 519843 791440 211970759 224989669 803045 818999 26333662 22024359 30328663 34663494 336399684 348719013 X 414988501 440185934 9034012 9934388 2021909 2141642 426044422 452261964 762444106 800980977 X 37100817 -10883275 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 33620 1 1723 0 0 35343 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: 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. 1 9654 113736 111545 11845 1 2021909 119733 2141642 1981042 40867 2021909 1897334 83708 1981042 2160515 -263181 1897334 1.00000 0 1 1 7249627 20252346 27501973 1245461 380803058 145624626 236423893 236755633 166830135 69925498 15014731 5258433 9756298 343607662 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 207116305 OTHER LIABILITIES 3446646 DUE TO OTHER ORGANIZATIONS 1174897 MARKET VALUE OF INTEREST SWAP 12592229 CAPITAL LEASE OBLIGATION 24459 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 12003995 DUE TO AFFILATE 5421268 34663494 719405956 682305139 37100817 -6031404 -4851871 -10883275 26217542 752038879 -6031404 50963178 44931774 707107105 12298851 12298851 719405956 723014035 60767086 60767086 662246949 20058190 20058190 682305139 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. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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 UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. PART XI, LINE 8 - OTHER ADJUSTMENTS: 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 XII, LINE 2D - 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 4B - 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 XIII, LINE 2D - 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 4B - 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. X X X X 1 RENAISSANCE GROUP INC 7701 DOUGLAS AVENUE DES MOINES IA 50322 COUNSEL FOR FUNDRAISING CAMPAIGN SERVICES 0 0 67066 -67066 67066 -67066 1 1 X 1 X 1 X 1 1 0 1 1 10414956 10414956 0.01530 65128812 47217235 17911577 0.02630 1163145 666176 496969 0.00070 76706913 47883411 28823502 0.04230 3013948 298779 2715169 0.00400 6862988 1576515 5286473 0.00770 50528552 43510527 7018025 0.01030 3928027 2728 3925299 0.00580 1883011 1883011 0.00280 66216526 45388549 20827977 0.03060 142923439 93271960 49651479 0.07290 107846 107846 0.00020 15000 15000 0.00000 258086 258086 0.00040 380932 380932 0.00060 1 18283341 0 142661645 123224808 19436837 X 1 1 7 1 AVERA MCKENNAN

1325 S CLIFF AVE SIOUX FALLS SD 57117

X X X X X X 30 PROVIDER BASED CLINICS 2 HEART HOSPITAL OF SOUTH DAKOTA LLC

10720 SIKES PLACE SUITE 300 CHARLOTTE NC 28277

X X X 2/3 OWNER IN JOINT VENTURE 3 AVERA GREGORY HEALTHCARE CENTER

400 PARK AVE GREGORY SD 57533

X X X X FOUR PROVIDER BASED CLINICS 4 AVERA MILBANK AREA HOSPITAL

901 VIRGIL AVE MILBANK SD 57252

X X X X THREE RURAL HEALTH PROVIDER BASED CLINICS 5 AVERA DELLS AREA HEALTH CENTER

909 N IOWA AVENUE DELL RAPIDS SD 57022

X X X X THREE PROVIDER BASED CLINICS 6 AVERA FLANDREAU MEDICAL CENTER

214 N PRAIRIE FLANDREAU SD 57028

X X X X ONE PROVIDER BASED CLINIC 7 AVERA HAND COUNTY MEMORIAL HOSPITAL

300 W 5TH ST MILLER SD 57362

X X X X ONE PROVIDER BASED CLINIC 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 67 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 AVE SIOUX FALLS SD 57105

RETAIL PHARMACY 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 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. 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 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 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 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 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 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 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 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. 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. PART VI, LINE 6 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. 1 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 155573 FMV RENTED SPACE DONATION 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 PLAZA 2 STE 210 SIOUX FALLS SD 57105 460448030 501(C)(3) 32000 DONATION 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 46 6 SCHOLARSHIPS 56 125000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: 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. 1 0 0 0 0 0 0 0 0 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 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. SUPPLEMENTAL INFORMATION 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. HAMID ABBASI PHYSICIAN RECRUITMENT X 100000 20833 0 1 1 20833 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 X ECARE EQUIPMENT 1 73149 COST OF DONATED PROPERTY 0 0 0 0 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. 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