AVERA MCKENNAN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: AVERA MCKENNAN (EIN 46-0224743)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-05-15
IRS object ID: 201221369349303117
Schema version: 2010v3.4
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	2012-05-15T10:49:27-05:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

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	2010-07-01	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	2012-05-14	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KIM HUNWARDSEN CPA	Name
Phone	6122536500	Phone
Date Prepared	2012-05-14	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2010	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	677957932	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	19	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	6090	TotalNbrEmployees
Total Nbr Volunteers	1100	TotalNbrVolunteers
Total Gross UBI	4960309	TotalGrossUBI
Net Unrelated Business Txbl Income	924940	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	3451139	ContributionsGrantsPriorYear
Contributions Grants Current Year	7931949	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	596067216	ProgramServiceRevenuePriorYear
Program Service Revenue CY	662236185	ProgramServiceRevenueCY
Investment Income Prior Year	553875	InvestmentIncomePriorYear
Investment Income Current Year	5052503	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2763167	OtherRevenuePriorYear
Other Revenue Current Year	1840244	OtherRevenueCurrentYear
Total Revenue Prior Year	602835397	TotalRevenuePriorYear
Total Revenue Current Year	677060881	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	3322297	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	4118418	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	311726810	SalariesEtcPriorYear
Salaries Etc Current Year	338604378	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	54527	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	61855	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	841473	TotalFundrsngExpCurrentYear
Other Expense Prior Year	256769316	OtherExpensePriorYear
Other Expenses Current Year	285920426	OtherExpensesCurrentYear
Total Expenses Prior Year	571872950	TotalExpensesPriorYear
Total Expenses Current Year	628705077	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	30962447	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	48355804	RevenuesLessExpensesCY
Total Assets BOY	696072011	TotalAssetsBOY
Total Assets EOY	762444106	TotalAssetsEOY
Total Liabilities BOY	333428534	TotalLiabilitiesBOY
Total Liabilities EOY	336399684	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	362643477	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	426044422	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	296476547	Expense
Grants	4076336	Grants
Revenue	429657256	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	33353300	Expense
Grants	7183	Grants
Revenue	44105195	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	171490344	Expense
Grants	34163	Grants
Revenue	143908502	Revenue
Description	CLINICSAVERA MCKENNAN PROVIDES CLINICAL CARE, SECONDARY AND PRIMARY, IN 67 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 2011 TOTALED 988,817.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	28945657	Expense
Grants	736	Grants
Revenue	40266632	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 SEVERAL CLINICAL 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 2011 PARTICIPATED IN 90 CLINICAL TRIALS, INVOLVING CANCER, ALZHEIMER'S DISEASE, HYPERCHOLESTEROLEMIA, RHEUMATOID ARTHRITIS, AND MORE. IN FISCAL YEAR 2011, AVERA MCKENNAN OPERATED THE AVERA RESEARCH INSTITUTE AT A LOSS OF $2,932,000.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	28945657	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	736	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	40266632	TotalOfOtherProgramServiceRev
Total Program Service Expense	530265848	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
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	418	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	6090	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	19	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	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 (32 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
FREDRICK W SLUNECKA
PRESIDENT & CEO	40.00	X	X	0	941800	26824
DAVE KAPASKA DO
PRESIDENT & CEO	40.00	X	X	382913	80124	23051
CATHY CLARK
BOARD TRUSTEE	2.00	X		0	0	0
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		309442	0	32746
SISTER JOAN REICHELT
BOARD TRUSTEE	2.00	X		0	0	0
DAVE STRAND MD
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
JULIE N NORTON
SEC/TREAS & SRVP FINANCE	40.00		X	348019	0	38762
JUDY BLAUWET
SR VICE PRESIDENT	40.00			324861	0	31350	X
DAVID FLICEK
SR VICE PRESIDENT	40.00			354350	84548	34537	X
STEVE PETERSEN
DIRECTOR-PHARMACY	40.00			173126	0	29873	X
PATRICIA JAGOE
AVP-SURGERY	40.00			173521	0	29175	X
CURT HOHMAN
SR VICE PRESIDENT	40.00			266315	0	24593	X
MICHAEL PUUMALA MD
PHYSICIAN	40.00			1066397	0	34602		X
HAMID ABBASI MD
PHYSICIAN	40.00			1260054	0	37002		X
BRIAN KNUTSON MD
PHYSICIAN	40.00			994393	0	37602		X
DANIEL TYNAN MD
PHYSICIAN	40.00			1304533	0	35720		X
STEVEN CONDRON MD
PHYSICIAN	40.00			1168974	0	39602		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	8126898	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1106472	TotalReportableCompFrmRltdOrgs
Total Other Compensation	455439	TotalOtherCompensation
Number Individuals GT100 K	431	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
SIOUX FALLS CONSTRUCTION
PO BOX 2728	SIOUX FALLS	SD	571072728	CONSTRUCTION	25953949
AVERA HEALTH
3900 WEST AVERA DRIVE	SIOUX FALLS	SD	57108	SHARED SERVICES	19700213
SANFORD SCHOOL OF MEDICINE
1400 W 22ND ST 120	SIOUX FALLS	SD	571051505	PHYSICIAN SERVICES	2505659
HENKIN SCHULTZ INC
6201 S PINNACLE PL	SIOUX FALLS	SD	571045716	ADVERTISING	1841402
ASSOCIATED REGIONAL & UNIVERSITY PATHOLO
PO BOX 27964	SALT LAKE CITY	UT	84127	LAB TESTING	1720356

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	86	NumberOfContractorsGT100K
Federated Campaigns	47851	FederatedCampaigns
Related Organizations	1520972	RelatedOrganizations
Government Grants	1767814	GovernmentGrants
All Other Contributions	4595312	AllOtherContributions
Noncash Contributions	2195260	NoncashContributions
Total Contributions	7931949	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	614135791	614135791
OTHER PATIENT AND CLIN	621500	30951899	26840021	4111878
INCOME FROM SUBSIDIARI	423000	8082750	7913058	169692
INTEREST IN FOUNDATION	900099	3042503	3042503
PROGRAM RENT	900099	1569295	1569295

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4453947	TotalRevenueColumn
Related Or Exempt Function Income	4436917	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	17030	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	662236185	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	328471	TotalRevenueColumn
Exclusion	$328,471	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	939780	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	843679	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	96101	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	96101	TotalRevenueColumn
Exclusion	$96,101	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	4658124	Securities
Other	119280	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	53372	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	4658124	Securities
Other	65908	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	4724032	TotalRevenueColumn
Exclusion	$4,724,032	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
INTEREST INCOME	900099	1082434	$1,082,434
COMMERCIAL TESTING	621500	621607		621607
MANAGEMENT SERVICES	541610	40102		40102

Field	Value	IRS element (for citing)
Total Other Revenue	1744143	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	677060881	TotalRevenueColumn
Related Or Exempt Function Income	657937585	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	4960309	UnrelatedBusinessRevenue
Exclusion	$6,231,038	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	4025918	Total
Program Services	4025918	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	92500	Total
Program Services	92500	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2035669	Total
Program Services	715178	ProgramServices
Management And General	1320491	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	159354	Total
Program Services	159354	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	271397519	Total
Program Services	247658681	ProgramServices
Management And General	23375560	ManagementAndGeneral
Fundraising	363278	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	15962800	Total
Program Services	14142693	ProgramServices
Management And General	1793181	ManagementAndGeneral
Fundraising	26926	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	32332544	Total
Program Services	28592137	ProgramServices
Management And General	3688448	ManagementAndGeneral
Fundraising	51959	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	16716492	Total
Program Services	14976795	ProgramServices
Management And General	1714521	ManagementAndGeneral
Fundraising	25176	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	165140	Total
Program Services	165140	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	344969	Total
Program Services	1890	ProgramServices
Management And General	343079	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	36200	Total
Program Services	3143	ProgramServices
Management And General	33057	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	40235	Total
Management And General	40235	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	61855	Total
Fundraising	61855	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	78658728	Total
Program Services	45828184	ProgramServices
Management And General	32829972	ManagementAndGeneral
Fundraising	572	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3612945	Total
Program Services	443145	ProgramServices
Management And General	3160479	ManagementAndGeneral
Fundraising	9321	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	9434876	Total
Program Services	4446167	ProgramServices
Management And General	4759175	ManagementAndGeneral
Fundraising	229534	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	7600092	Total
Program Services	974014	ProgramServices
Management And General	6626078	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	19301477	Total
Program Services	13218277	ProgramServices
Management And General	6029759	ManagementAndGeneral
Fundraising	53441	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	2727431	Total
Program Services	2286642	ProgramServices
Management And General	435045	ManagementAndGeneral
Fundraising	5744	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1720267	Total
Program Services	1487756	ProgramServices
Management And General	231440	ManagementAndGeneral
Fundraising	1071	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	7871945	Total
Program Services	7631092	ProgramServices
Management And General	240853	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	29938840	Total
Program Services	23630213	ProgramServices
Management And General	6304414	ManagementAndGeneral
Fundraising	4213	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1177597	Total
Program Services	1176937	ProgramServices
Management And General	660	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES	94557406	93935591	617135	4680
BAD DEBT	19596381	19569519	26862
EQUIPMENT LEASE AND REN	4667112	3714058	953054
LICENSES AND PERMITS	1170752	576036	594716
UBI TAX	354297	354297

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2943736	Total
Program Services	460491	ProgramServices
Management And General	2479542	ManagementAndGeneral
Fundraising	3703	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	628705077	Total
Program Services	530265848	ProgramServices
Management And General	97597756	ManagementAndGeneral
Fundraising	841473	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	24167419	BOY
EOY	26868405	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	3781641	BOY
EOY	3360173	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	80278346	BOY
EOY	85293914	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	58333	BOY
EOY	120833	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	3496249	BOY
EOY	3431202	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	11076812	BOY
EOY	12517902	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5172280	BOY
EOY	5340257	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	619717477	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	284576477	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	315906702	BOY
EOY	335141000	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	55378107	BOY
EOY	23658088	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	152452866	BOY
EOY	202453890	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	5104920	BOY
EOY	6876999	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	26488947	BOY
EOY	42209593	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	12709389	BOY
EOY	15171850	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	696072011	BOY
EOY	762444106	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	65243074	BOY
EOY	66443712	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	2156365	BOY
EOY	519843	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	215394148	BOY
EOY	211970759	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	9188968	BOY
EOY	803045	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	9305204	BOY
EOY	26333662	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	32140775	BOY
EOY	30328663	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	333428534	BOY
EOY	336399684	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	353311977	BOY
EOY	414988501	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7350458	BOY
EOY	9034012	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1981042	BOY
EOY	2021909	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	362643477	BOY
EOY	426044422	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	696072011	BOY
EOY	762444106	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	48355804	ReconcilationRevenueExpenses
Reconcilation Other Changes	15045141	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	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

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	$32,249	GrantsOtherOrganizationsAmount
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$7,986	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	40235	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	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. IN ADDITION, AVERA MCKENNAN REPRESENTATIVES HAVE PROVIDED INFORMATION TO THE LEGISLATORS REGARDING THE PURPOSE OF THE MEDICARE CHRONIC CARE PRACTICE RESEARCH NETWORK (MCCPRN) AND PROMOTED THEIR SUPPORT FOR FINANCING OF MCCPRN. 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	11634	BeginningBalance
Additions During Year	126534	AdditionsDuringYear
Distributions During Year	128514	DistributionsDuringYear
Ending Balance	9654	EndingBalance
Included On FS	1	IncludedOnFS

Current Year CurrentYear

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 Minus1 Year CurrentYearMinus1Year

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 Minus2 Years CurrentYearMinus2Years

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	6159099	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	19064389	OtherCostOrOtherBasis
Book Value	25223488	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1313277	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	366696593	OtherCostOrOtherBasis
Depreciation	133692626	Depreciation
Book Value	234317244	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	215658349	OtherCostOrOtherBasis
Depreciation	145956990	Depreciation
Book Value	69701359	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	10825770	OtherCostOrOtherBasis
Depreciation	4926861	Depreciation
Book Value	5898909	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	335141000	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
ASSETS LIMITED AS TO USE - AVERA POOLED INVESTMENTS	170814066	F
AVERA HOME MEDICAL EQUIPMENT, LLC	3858658	C
INTEREST IN AVERA HEALTH FOUNDATION	9923336	F
INVESTMENTS IN AFFILIATED COMPANIES	4047826	C
MIDWEST REGIONAL IMAGING SERVICES, LLC	879073	C
HEART HOSPITAL OF SOUTH DAKOTA, LLC	12930931	C

Field	Value	IRS element (for citing)
Total Of Book Value Securities	202453890	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
OTHER LIABILITIES	$3,037,061
DUE TO OTHER ORGANIZATIONS	$1,174,897
MARKET VALUE OF INTEREST SWAP	$7,333,347
CAPITAL LEASE OBLIGATION	$80,692
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$13,113,706
DUE TO AFFILATE	$5,588,960

Field	Value	IRS element (for citing)
Total Of Amounts	30328663	TotalOfAmounts
Total Revenue	677060881	TotalRevenue
Total Expenses	628705077	TotalExpenses
Excess Or Deficit For Year	48355804	ExcessOrDeficitForYear
Net Unrealized GL On Investments	15424833	NetUnrealizedGLOnInvestments
Other	-$379,692	OtherAmount
Total Adjustments	15045141	TotalAdjustments
Excess Or Deficit Per FS	63400945	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	739797892	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	15424833	NetUnrealizedGainsInvestments
Other Revenues	65215380	OtherRevenues
Revenue Not Rptd F990	80640213	RevenueNotRptdF990
Revenue Subtotal	659157679	RevenueSubtotal
Other Revenues Not Included	17903202	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	17903202	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	677060881	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	677284434	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	48579357	OtherExpensesIncluded
Expenses Not Rptd F990	48579357	ExpensesNotRptdF990
Expenses Subtotal	628705077	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	628705077	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (8 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 BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE 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 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
	BOOK/TAX ADJUSTMENTS ON PARTNERSHIPS -4,060,453. EQUITY TRANSFERS, NET -699,541. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,346,111. INCOME FROM GRANTOR TRUST NOT INCLUDED ON FINANCIAL STATEMENTS 366,789. LOSS ON RETIREMENT OF DEBT -253,242. CHANGE IN ACCOUNTING PRINCIPLES -1,918,602. OTHER CHANGES IN NET ASSETS 318,029. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP DESIGNATED AS HEDGE -718,740. STEP UP BASIS OF ASSETS FROM ACQUISITION OF HEART HOSPITAL OF SOUTH DAKOTA 5,083,056. CHANGE IN NONCONTROLLING INTEREST OF HEART HOSPITAL OF SOUTH DAKOTA LLC 156,901.	PART XI, LINE 8 - OTHER ADJUSTMENTS:
	REVENUES OF CONSOLIDATED SUBSIDIARIES CONSOLIDATED FOR FINANCIAL STATEMENTS 61,332,017. OCCUPANCY EXPENSES INCLUDED IN NONOPERATING INCOME ON FINANCIAL STATEMENTS -1,911,822. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP RECORDED IN N/A FOR TAX RETURN 1,346,111. 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 -253,242. STEP UP BASIS OF ASSETS FROM ACQUISITION OF HEART HOSPITAL OF SOUTH DAKOTA 5,083,056.	PART XII, LINE 2D - OTHER ADJUSTMENTS:
	CHANGE IN INVESTMENT IN AVERA HEALTH FDTN RECORDED IN FUND BALANCE ON F/S 2,347,440. MINORITY INTEREST SHARE OF GAINS FROM SUBSIDIARIES -46,424. GAIN FROM INVESTMENT IN SUBSIDIARIES RECORDED IN REVENUE FOR TAX RETURN 7,588,472. MANAGEMENT FEES INCLUDED IN EXPENSES ON FINANCIAL STATEMENTS 669,839. BOOK/TAX ADJUSTMENTS ON PARTNERSHIPS 4,060,453. RENTAL EXPENSE INCLUDED IN REVENUES ON FINANCIAL STATEMENTS -843,679. INCOME FROM GRANTOR TRUST NOT INCLUDED ON FINANCIAL STATEMENTS -366,789. CONTRIBUTION OF LONG-LIVED ASSET RECORDED IN NET ASSETS FOR FINANCIAL STMT 4,493,890.	PART XII, LINE 4B - OTHER ADJUSTMENTS:
	EXPENSES OF CONSOLIDATED SUBSIDIARIES CONSOLIDATED FOR FINANCIAL STATEMENTS 50,317,339. MANAGEMENT FEES INCLUDED IN REVENUE FOR TAX RETURN -669,839. RENTAL EXPENSE INCLUDED IN EXPENSES FOR TAX RETURN 843,679. OCCUPANCY EXPENSES INCLUDED IN NONOPERATING INCOME ON FINANCIAL STATEMENTS -1,911,822.	PART XIII, LINE 2D - OTHER ADJUSTMENTS:

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Solicitation Of Non Govt Grants	X	SolicitationOfNonGovtGrants
Solicitation Of Govt Grants	X	SolicitationOfGovtGrants
Agreement Ref Fundraising	1	AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Name Of IndividualNameOfIndividual	Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	ActivityActivity	Fundraiser Control Of FundsFundraiserControlOfFunds	Gross ReceiptsGrossReceipts	Amount Retained By ContractorAmountRetainedByContractor	Net To OrganizationNetToOrganization
JON OIEN	600 EAST SUNNYBROOK DRIVE	SIOUX FALLS	SD	57105	CONSULTING SERVICES	0	0	19855	-19855
THEODORE R MUENSTER	509 LINDEN AVE	VERMILLION	SD	57069	CONSULTING SERVICES	0	0	42000	-42000

Field	Value	IRS element (for citing)
Total Retained By Contractors	61855	TotalRetainedByContractors
Total Net To Organization	-61855	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	9620376	TotalCommunityBenefitExpense
Net Community Benefit Expense	9620376	NetCommunityBenefitExpense
Percent Of Total Expense	0.01570	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	61046028	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50064558	DirectOffsettingRevenue
Net Community Benefit Expense	10981470	NetCommunityBenefitExpense
Percent Of Total Expense	0.01790	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1061747	TotalCommunityBenefitExpense
Direct Offsetting Revenue	646274	DirectOffsettingRevenue
Net Community Benefit Expense	415473	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	71728151	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50710832	DirectOffsettingRevenue
Net Community Benefit Expense	21017319	NetCommunityBenefitExpense
Percent Of Total Expense	0.03430	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2628443	TotalCommunityBenefitExpense
Direct Offsetting Revenue	236775	DirectOffsettingRevenue
Net Community Benefit Expense	2391668	NetCommunityBenefitExpense
Percent Of Total Expense	0.00390	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5513068	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1551377	DirectOffsettingRevenue
Net Community Benefit Expense	3961691	NetCommunityBenefitExpense
Percent Of Total Expense	0.00650	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	56396742	TotalCommunityBenefitExpense
Direct Offsetting Revenue	48496107	DirectOffsettingRevenue
Net Community Benefit Expense	7900635	NetCommunityBenefitExpense
Percent Of Total Expense	0.01290	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4685516	TotalCommunityBenefitExpense
Direct Offsetting Revenue	684087	DirectOffsettingRevenue
Net Community Benefit Expense	4001429	NetCommunityBenefitExpense
Percent Of Total Expense	0.00650	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2581483	TotalCommunityBenefitExpense
Net Community Benefit Expense	2581483	NetCommunityBenefitExpense
Percent Of Total Expense	0.00420	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	71805252	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50968346	DirectOffsettingRevenue
Net Community Benefit Expense	20836906	NetCommunityBenefitExpense
Percent Of Total Expense	0.03400	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	143533403	TotalCommunityBenefitExpense
Direct Offsetting Revenue	101679178	DirectOffsettingRevenue
Net Community Benefit Expense	41854225	NetCommunityBenefitExpense
Percent Of Total Expense	0.06830	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	59457	TotalCommunityBuildingExpense
Net Community Building Expense	59457	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	950	TotalCommunityBuildingExpense
Net Community Building Expense	950	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	5000	TotalCommunityBuildingExpense
Net Community Building Expense	5000	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	269121	TotalCommunityBuildingExpense
Net Community Building Expense	269121	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	334528	TotalCommunityBuildingExpense
Net Community Building Expense	334528	NetCommunityBuildingExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$10,398,840	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	144579444	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	137438922	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	7140522	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	14 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 MILBANK AREA HOSPITAL
3	901 VIRGIL AVE	MILBANK	SD	57252	X	X				X	THREE RURAL HEALTH PROVIDER BASED CLINICS	X
AVERA GREGORY HEALTHCARE CENTER
4	400 PARK AVE	GREGORY	SD	57533	X	X				X	FOUR 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

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NOT REQUIRED	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	72	NumberOfOtherFacilities

Other Facilities OtherFacilities (72 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
AVERA MCKENNAN BEHAVIORAL HEALTH CENTER
4400 W 69TH ST	SIOUX FALLS	SD	57108	INPATIENT & OUTPATIENT BEHAVIORAL HEALTH SERVICES
AVERA MEDICAL GROUP (AMG) PIERRE
100 MAC LANE	PIERRE	SD	57501	PRIMARY AND SPECIALTY CLINIC; OUTPATIENT SURGERY CENTER
AVERA MEDICAL GROUP MCGREEVY 7TH AVENUE
1200 SOUTH 7TH AVENUE	SIOUX FALLS	SD	57105	PRIMARY CARE CLINIC
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 AND SPECIALTY CARE CLINIC
AVERA MEDICAL GROUP WORTHINGTON
508 TENTH STREET	WORTHINGTON	MN	56187	PRIMARY AND SPECIALTY CARE CLINIC
AVERA MEDICAL GROUP SPENCER
116 EAST 11TH SUITE 101	SPENCER	IA	51301	PRIMARY CARE CLINIC
AVERA MCKENNAN HOME INFUSION
1020 S CLIFF AVENUE	SIOUX FALLS	SD	57105	COMPREHENSIVE HOME INFUSION THERAPIES & SUPPLIES
AVERA PRINCE OF PEACE
4500 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	SKILLED NURSING FACILITY AND SENIOR HOUSING
PET CT LLC
6001 SHARON AVENUE	SIOUX FALLS	SD	57108	RADIOLOGY PET/CT SERVICES
AVERA MEDICAL GROUP OB GYN
1417 SOUTH CLIFF AVENUE SUITE 401	SIOUX FALLS	SD	57105	WOMENS SERVICES CLINIC
MCKENNAN REGIONAL LABORATORY
1325 S CLIFF AVENUE	SIOUX FALLS	SD	57105	LABORATORY SERVICES
AVERA MEDICAL GROUP NEUROSURGERY
1301 SOUTH CLIFF AVENUE SUITE 610	SIOUX FALLS	SD	57105	NEUROSURGERY CLINIC
AVERA MEDICAL GROUP GASTROENTEROLOGY
1417 SOUTH CLIFF AVENUE SUITE 300	SIOUX FALLS	SD	57105	GASTROENTEROLOGY CLINIC
AVERA PLAZA 2 PHARMACY
1301 S CLIFF AVENUE	SIOUX FALLS	SD	57105	RETAIL PHARMACY
AVERA HOME MEDICAL EQUIPMENT
2400 S MINNESOTA AVE	SIOUX FALLS	SD	57105	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
RADIATION THERAPY
1417 S MINNESOTA AVE	SIOUX FALLS	SD	57105	RADIATION THERAPY SERVICES
AVERA MEDICAL GROUP MCGREEVY W 41ST ST
6000 WEST 41ST STREET	SIOUX FALLS	SD	57106	PRIMARY CARE CLINIC
AMG MATERNAL FETAL MEDICINE
1417 SOUTH CLIFF AVENUE SUITE 100	SIOUX FALLS	SD	57105	HIGH-RISK PREGNANCY CARE CLINIC
AVERA MEDICAL GROUP SPIRIT LAKE MEDICAL
2700 - 23RD STREET SUITE A	SPIRIT LAKE	IA	51360	PRIMARY AND SPECIALTY CARE CLINIC
AVERA MEDICAL GROUP PEDIATRIC SPECIALIST
1417 S CLIFF AVENUE SUITE 010	SIOUX FALLS	SD	57105	PEDIATRIC SPECIALTIES CLINIC
AVERA MCKENNAN HOSP & UNIVERSITY HEALTH
1325 S CLIFF AVENUE	SIOUX FALLS	SD	57105	RETAIL PHARMACY
DOUGHERTY HOSPICE HOUSE
4509 PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	HOSPICE CARE
AMG MCGREEVY 69TH & WESTERN
1910 WEST 69TH STREET	SIOUX FALLS	SD	57108	PRIMARY CARE CLINIC
AVERA MCKENNAN FITNESS CENTER
3400 S SOUTHEASTERN DRIVE	SIOUX FALLS	SD	57105	FITNESS CENTER
AMG LAKES FAMILY PRACTICE
2700 - 23RD STREET SUITE C	SPIRIT LAKE	IA	51360	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP MCGREEVY SOUTHEASTER
3400 SOUTH SOUTHEASTERN AVENUE	SIOUX FALLS	SD	57103	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 MEDICAL GROUP MCGREEVY BRANDON
1101 EAST HOLLY BOULEVARD	BRANDON	SD	57005	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP UROGYNECOLOGY
1417 SOUTH CLIFF AVENUE SUITE 101	SIOUX FALLS	SD	57105	UROLOGY & OB/GYN DISORDERS CLINIC
AVERA HOME MEDICAL EQUIPMENT
418 S 2ND STREET	ABERDEEN	SD	57401	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA HOME MEDICAL EQUIPMENT
1001 W 9TH STREET	YANKTON	SD	57078	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AVERA INSTITUTE FOR HUMAN GENETICS
4400 W 69TH ST SUITE 200	SIOUX FALLS	SD	57108	GENETIC RESEARCH PROGRAM
AVERA HOME MEDICAL EQUIPMENT
1307 N MAIN	MITCHELL	SD	57301	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
LAUREL OAKS APARTMENTS
4510 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	INDEPENDENT LIVING APARTMENTS
AVERA RESEARCH INSTITUTE
2020 S NORTON AVE	SIOUX FALLS	SD	57105	CLINICAL RESEARCH STUDIES
AVERA HOME MEDICAL EQUIPMENT
1411 WELLS AVE	PIERRE	SD	57501	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AMG OCCUPATIONAL MEDICINE
4928 NORTH CLIFF AVENUE	SIOUX FALLS	SD	57104	BUSINESS AND CORPORATE HEALTH CARE 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 MEDICAL GROUP SIBLEY
600-9TH AVENUE NORTH	SIBLEY	IA	51249	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT (HME)
602 CENTRAL AVE	ESTHERVILLE	IA	51334	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
AMG TRANSPLANT & LIVER SURGERY
1315 SOUTH CLIFF AVENUE SUITE 1100	SIOUX FALLS	SD	57105	VASCULAR AND SOLID ORGAN TRANSPLANT CLINIC
AVERA HME FLOYD VALLEY HOSPITAL
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 LARCHWOOD
916 HOLDER STREET PO BOX 8	LARCHWOOD	IA	51241	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP WOMEN'S MIDLIFE CARE
911 EAST 20TH STREET - SUITE 200	SIOUX FALLS	SD	57105	WOMEN'S SERVICES CLINIC
AVERA MEDICAL GROUP HARRISBURG
220 SOUTH CLIFF SUITE 120	HARRISBURG	SD	57032	PRIMARY CARE CLINIC
AVERA HOME MEDICAL EQUIPMENT
800 E 21ST STREET	SIOUX FALLS	SD	57117	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 MEDICAL GROUP TEA
725 FIGZEL COURT - SUITE 100	TEA	SD	57064	PRIMARY CARE CLINIC
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
PIPESTONE MEDICAL GROUP AVERA
920 - 4TH AVENUE SW	PIPESTONE	MN	56164	PRIMARY CARE CLINIC
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
COMMUNITY BLOOD BANK
1301 SOUTH CLIFF AVENUE SUITE 3	SIOUX FALLS	SD	57105	COMMUNITY BLOOD SERVICES
HEGG MEDICAL CLINIC AVERA
2121 HEGG DRIVE	ROCK VALLEY	IA	51247	PRIMARY CARE CLINIC
AVERA HME OF SPENCER HOSPITAL
716 GRAND AVE	SPENCER	IA	51301	RENTAL & SALE OF HOME MEDICAL EQUIPMENT
YORKSHIRE EYE CLINIC
2311 YORKSHIRE DRIVE	BROOKINGS	SD	57006	OPHTHALMOLOGY AND OPTOMETRY CLINIC
RURAL MEDICAL CLINICS
301 SOUTH WALNUT STREET	FREEMAN	SD	57029	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP ESTHERVILLE
926 NORTH 8TH STREET	ESTHERVILLE	IA	51334	PRIMARY CARE CLINIC
AVERA MEDICAL GROUP CHAMBERLAIN
101 SOUTH FRONT PO BOX 27	CHAMBERLAIN	SD	57325	PRIMARY CARE 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 (16 entries)

ExplanationExplanation	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 $8,759,020 AND COSTS OF $12,018,332 WERE INCLUDED FOR A NET COMMUNITY BENEFIT OF $3,259,312. 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 $19,596,381 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: COSTING METHODOLOGY USED TO REPORT BAD DEBT EXPENSE (AT COST) WAS A COST TO CHARGE RATIO AS OUTLINED IN WORKSHEET 2 RATIO OF PATIENT CARE COSTS TO CHARGES.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.THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. MANAGEMENT ALSO REVIEWS ACCOUNTS TO DETERMINE IF CLASSIFICATION AS CHARITY CARE IS APPROPRIATE.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. SCHEDULE H INSTRUCTIONS ALSO REQUIRE THE EXCLUSION OF $991,045 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 $25,767,954 AS OPPOSED TO A SURPLUS OF $7,140,522.
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 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 115 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 2010 U.S. CENSUS BUREAU DATA ESTIMATES 10% OF RESIDENTS IN THE PRIMARY SERVICE AREA ARE AT OR BELOW THE POVERTY LEVEL. OUR SECONDARY SERVICE AREA COVERS AN ADDITIONAL 17 COUNTIES IN SOUTH DAKOTA, IOWA AND MINNESOTA WITH AN ESTIMATED TOTAL POPULATION OF 226,000 BASED ON U.S. CENSUS BUREAU PROJECTIONS FOR 2009.
PART VI, LINE 6: SURPLUS FUNDS ARE REINVESTED IN FACILTIES 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 OPERATES AN EMERGENCY CENTER STAFFED 24 HOURS A DAY WITH BOARD-CERTIFIED EMERGENCY SPECIALISTS AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. IN ADDITION THE FACILITY OPERATES BOTH FIXED WING AND HELICOPTER MEDICAL AIR TRANSPORTS COVERING A LARGE GEOGRAPHIC AREA PROVIDING ACCESS TO CRITICAL CARE. THROUGH AN INTEGRATED NETWORK OF CLINIC PROVIDERS THE ORGANIZATION PROVIDES NON-EMERGENCY SERVICES TO THE COMMUNITIES 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 FIVE RURAL CRITICAL ACCESS HOSPITALS WHICH PROVIDE A BROAD VARIETY OF INPATIENT AND OUTPATIENT SERVICES AND 24-HOUR EMERGENCY ROOMS. TELEMEDICINE CONSULTS ARE ALSO OFFERED AT RURAL LOCATIONS IN A NUMBER OF MEDICAL SPECIALTIES. BOTH IN THE TERTIARY MEDICAL CENTER AND IN RURAL FACILITIES, EICU TECHNOLOGY OFFERS CONSTANT, AROUND-THE-CLOCK MONITORING AND INTERVENTIONS IN THE INTENSIVE CARE UNITS FROM A REMOTE CARE TEAM IN ADDITION TO THE CARE THEY RECEIVE FROM THEIR BEDSIDE TEAM. THE SERVICE IS PROVIDED ON A CONTRACT BASIS TO HOSPITALS SO THERE IS NO ADDITIONAL CHARGE TO THE PATIENT. THIS ENABLES CRITICALLY ILL PATIENTS TO RECEIVE THE HIGHEST QUALITY CARE, CLOSE TO HOME, WITH THE SUPPORT OF FAMILY AND FRIENDS.AVERA MCKENNAN HAS MEDICAL SCHOOL RESIDENTS IN TRAINING AT AVERA MCKENNAN IN INTERNAL MEDICINE, FAMILY PRACTICE, PSYCHIATRY AND TRANSITIONAL RESIDENCY PROGRAMS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA SANFORD SCHOOL OF MEDICINE. OVER 800 STUDENTS IN NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, RADIOLOGY AND RESPIRATORY THERAPY ALSO COMPLETE 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 OFFERS UNPAID INTERNSHIPS IN THE AREAS OF MARKETING, HUMAN RESOURCES, FOUNDATION, NETWORK OPERATIONS AND PROCESS EXCELLENCE, WORKING WITH APPROXIMATELY 22 INSTITUTIONS OF HIGHER EDUCATION.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 SEVERAL CLINICAL 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 2011 PARTICIPATED IN 90 CLINICAL TRIALS, INVOLVING CANCER, ALZHEIMER'S DISEASE, HYPERCHOLESTEROLEMIA, RHEUMATOID ARTHRITIS, AND MORE.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 PEOPLE. THROUGHOUT 2011, VIDEOS OF THESE PRESENTATIONS WERE VIEWED 583 TIMES ONLINE.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 2011, 179 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 975 ATTENDEES. A TOTAL OF 39 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 693 ATTENDEES. A TOTAL OF 211 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 2,869 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 38 SCHEDULED ANNUALLY, AND ADDITIONAL SESSIONS FOR REQUESTED TOPICS. 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 2011, THE MEDICAL CALL CENTER HANDLED 62,472 CALLS. AVERA MCKENNAN'S WEB SITE ALSO PROVIDES AN EXTENSIVE HEALTH LIBRARY THAT CONSUMERS CAN ACCESS FREE OF CHARGE.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 733 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 8,794 VISITS IN FISCAL YEAR 2011.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.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.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 $950. 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 2011, AVERA MCKENNAN ASSISTED WITH 93 BIRTHS AND PROVIDED 664 PRENATAL AND POST-PARTUM VISITS.
PART VI, LINE 7:
AVERA FAMILY WELLNESS 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 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 2011, THE WALSH FAMILY VILLAGE SERVED 7,063 GUESTS, STAYING IN 3,593 NIGHTLY ROOMS. IN 2011, AVERA MCKENNAN DELIVERED THREE TRUCKLOADS OF EXCESS MEDICAL EQUIPMENT, FURNITURE, CLOTHING AND SUPPLIES TO INDIAN RESERVATIONS IN SOUTH DAKOTA. WITH TRUCK RENTAL AND FUEL EXPENSE, EACH TRIP COST APPROXIMATELY $1,000 IN ADDITION TO THE DONATIONS.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.
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 (39 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
SIOUX FALLS CATHOLIC SCHOOLS
3100 W 41ST STREET	SIOUX FALLS	SD	57105	510145184	501(C)(3)	600000	DONATION
RONALD MCDONALD HOUSE
2001 S NORTON	SIOUX FALLS	SD	57105	460371152	501(C)(3)	45000	DONATION	147252	FMV	RENTED SPACE
USD FOUNDATION
1100 N DAKOTA	VERMILLION	SD	57069	466018891	501(C)(3)	246000	DONATION
FORWARD SIOUX FALLS
PO BOX 907	SIOUX FALLS	SD	57101	460396647	501(C)(6)	450265	DONATION
SIOUX EMPIRE UNITED WAY
1000 N WEST AVE 120	SIOUX FALLS	SD	57104	460233701	501(C)(3)	25215	DONATION
SOUTH DAKOTA STATE UNIVERSITY FOUNDATION
PO BOX 2218	BROOKINGS	SD	57007	460273801	501(C)(3)	1050892	DONATION
CATHOLIC DIOCESE
523 N DULUTH AVE	SIOUX FALLS	SD	57104	466000424	501(C)(3)	125196	DONATION
YWCA
300 W 11TH STREET	SIOUX FALLS	SD	57104	460234998	501(C)(3)	35000	DONATION
FACE IT SIOUX FALLS
PO BOX 5127	SIOUX FALLS	SD	57117	943472044	501(C)(3)	180830	DONATION
RIVER OF HOPE
PO BOX 1597	SIOUX FALLS	SD	57101	263130719	501(C)(3)	110000	DONATION
WASHINGTON PAVILION
PO BOX 984	SIOUX FALLS	SD	57101	460435791	501(C)(3)	44548	DONATION
HARRISBURG ACTIVITIES FOUNDATION
PO BOX 479	HARRISBURG	SD	57032	061749081	501(C)(3)	20000	DONATION
AMERICAN CANCER SOCIETY
4904 S TECHNOPOLIS DRIVE	SIOUX FALLS	SD	57106	131788491	501(C)(3)	26290	DONATION
TRANSITIONAL LIVING CORPORATION
2601 S MINNESOTA AVE STE 105-378	SIOUX FALLS	SD	57105	200293050	501(C)(3)	30000	DONATION
SOUTH DAKOTA SYMPHONY
315 N MAIN AVE SUITE 204	SIOUX FALLS	SD	571046078	466017026	501(C)(3)	77000	DONATION
NATIONAL KIDNEY FOUNDATION
1100 E 21ST STREET AVERA DOCTORS	SIOUX FALLS	SD	57105	460448030	501(C)(3)	9000	DONATION				PLAZA 2 STE 210
SIOUX FALLS JAZZ & BLUES SOCIETY
123 S MAIN AVE SUITE 204	SIOUX FALLS	SD	571046430	460418356	501(C)(3)	10000	DONATION
DAKOTA STATE UNIVERSITY
800 N WASHINGTON AVENUE	MADISON	SD	570421799	237299995	501(C)(3)	13659	DONATION
JUNIOR ACHIEVEMENT OF SOUTH DAKOTA
1000 N WEST AVE SUITE 110	SIOUX FALLS	SD	57104	460306352	501(C)(3)	11800	DONATION
WORTHINGTON YMCA
211 11TH ST	WORTHINGTON	MN	56187	416007596	501(C)(3)	9600	DONATION
SOUTH DAKOTA HUMANITIES COUNCIL
1215 TRAIL RIDGE RD	BROOKINGS	SD	57006	460316222	501(C)(3)	9000	DONATION
NAMI OF SOUTH DAKOTA
PO BOX 88808	SIOUX FALLS	SD	57109	363593027	501(C)(3)	7500	DONATION
SOUTH DAKOTA ACHIEVE
4100 S WESTERN AVE	SIOUX FALLS	SD	57105	237072116	501(C)(3)	7500	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)	6400	DONATION
FURNITURE MISSION OF SOUTH DAKOTA
209 N NESMITH	SIOUX FALLS	SD	57104	810584500	501(C)(3)	6000	DONATION
SALES & MARKETING EXECUTIVES
PO BOX 90310	SIOUX FALLS	SD	57109	466012934	501(C)(6)	5650	DONATION
FAMILY VISITATION CENTER
311 E 14TH ST	SIOUX FALLS	SD	57104	263654937	501(C)(3)	6000	DONATION
SOUTH DAKOTA CHORALE
300 S MINNESOTA AVE	SIOUX FALLS	SD	57104	460225435	501(C)(3)	10000	DONATION
AMYOTTOPHIC 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)	30000	DONATION
CHILDRENS HOME FOUNDATION
PO BOX 1749	SIOUX FALLS	SD	571011749	460366277	501(C)(3)	12000	DONATION
MCCROSSAN BOYS RANCH
47135 260TH STREET	SIOUX FALLS	SD	57107	460311913	501(C)(3)	10834	DONATION
SOUTH DAKOTA ASSOCIATION FOR CAREER AND TECHINICAL EDUCATION INC
230 11TH ST N	WATERTOWN	SD	572012869	460427245	501(C)(3)	10000	DONATION
SOUTH DAKOTA LIONS EYE BANK
4501 W 61ST ST N	SIOUX FALLS	SD	571076411	460413527	501(C)(3)	10000	DONATION
VOLUNTEERS OF AMERICA DAKOTAS
1401 W 51ST	SIOUX FALLS	SD	57105	237353508	501(C)(3)	10000	DONATION
BOYS AND GIRLS CLUB OF THE SIOUX EMPIRE
824 E 14TH ST	SIOUX FALLS	SD	571045221	460399482	501(C)(3)	9000	DONATION
SIOUX EMPIRE BASEBALL ASSOCIATION
1601 W 44TH PL SUITE 3	SIOUX FALLS	SD	57105	411903475	501(C)(3)	8667	DONATION
SIOUX FALLS STATE THEATRE COMPANY
101 N MAIN AVE	SIOUX FALLS	SD	58101	203473359	501(C)(3)	44983	DONATION

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	37	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	2	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	39	NumberOfRecipients
Amount Of Cash Grant	92500	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	0	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
FREDRICK W SLUNECKA
0	927393	0	0	0	14407	0	12250	0	16488	0	970538	0	0
DAVE KAPASKA DO
375995	79013	0	0	6918	1111	4900	2042	13680	2737	401493	84903	0	0
KIM PEDERSON MD
304993	0	0	0	4449	0	18498	0	14249	0	342189	0	0	0
JULIE N NORTON
347089	0	0	0	930	0	18498	0	20265	0	386782	0	0	0
JUDY BLAUWET
319089	0	0	0	5772	0	13598	0	17753	0	356212	0	0	0
DAVID FLICEK
352702	84267	0	0	1648	281	13598	3062	13540	4667	381488	92277	0	0
STEVE PETERSEN
171595	0	0	0	1531	0	9768	0	20105	0	202999	0	0	0
PATRICIA JAGOE
172707	0	0	0	814	0	13071	0	16105	0	202697	0	0	0
CURT HOHMAN
265434	0	0	0	881	0	18498	0	6095	0	290908	0	0	0
MICHAEL PUUMALA MD
1061335	0	0	0	5062	0	18498	0	16105	0	1101000	0	0	0
HAMID ABBASI MD
1257064	0	0	0	2990	0	18498	0	18505	0	1297057	0	0	0
BRIAN KNUTSON MD
991448	0	0	0	2945	0	18498	0	19105	0	1031996	0	0	0
DANIEL TYNAN MD
1297453	0	0	0	7080	0	18498	0	17222	0	1340253	0	0	0
STEVEN CONDRON MD
1166624	0	0	0	2350	0	18498	0	21105	0	1208577	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	SUPPLEMENTAL INFORMATION	Identifier
Return Reference	PART III	ReturnReference
Explanation	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.	Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable (4 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
MICHAEL PUUMALA
PHYSICIAN RECRUITMENT	X	$100,000	6250	0	1	1
DANIEL TYNAN
PHYSICIAN RECRUITMENT	X	$100,000	2083	0	1	1
HAMID ABBASI
PHYSICIAN RECRUITMENT	X	$100,000	37500	0	1	1
STEVEN CONDRON
PHYSICIAN RECRUITMENT	X	$200,000	75000	0	1	1

Field	Value	IRS element (for citing)
Total Balance Due	120833	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (11 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
MICHAEL BENDER
BOARD MEMBER	208716	PROPERTY LEASE	0
SURGICAL INSTITUTE OF SD
ENTITY CONTROLLED BY TWO BOARD MEMBERS	968635	TRAUMA CONTRACT AND ACUTE SURGICAL SERVICES CONTRACT	0
VICTORIA PETERSEN
FAMILY OF KEY EMPLOYEE	34299	EMPLOYEE COMPENSATION	0
AGNES KLEIN
FAMILY OF BOARD MEMBER	31420	EMPLOYEE COMPENSATION	0
ALEXANDER PETERSEN
FAMILY OF KEY EMPLOYEE	26570	EMPLOYEE COMPENSATION	0
JAMES HARTUNG
FAMILY OF KEY EMPLOYEE	77696	EMPLOYEE COMPENSATION	0
SIOUX FALLS CONSTRUCTION CO
BOARD MEMBER IS AN OFFICER OF THE ENTITY	13156813	CONSTRUCTION	0
STEVEN REICHELT
FAMILY OF BOARD MEMBER	22376	EMPLOYEE COMPENSATION	0
NEUROLOGY ASSOCIATES
BOARD MEMBER IS A GREATER THAN 5% PARTNER IN THE ENTITY	492890	ER CALL COVERAGE	0
US BANK
BOARD MEMBER IS AN OFFICER OF THE ENTITY	797875	BANK FEES AND INTEREST	0
NEUROLOGY ASSOCIATES
BOARD MEMBER IS A GREATER THAN 5% PARTNER IN THE ENTITY	-769296	RENTED SPACE AND RENTED EQUIPMENT FROM MCKENNAN	0

Schedule M IRS990ScheduleM

Real Estate Other RealEstateOther

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	1	NumberOfContributions
Noncash Contribs Rptd F990	1629495	NoncashContribsRptdF990
Method Of Determining Revenues	INDEPENDENT APPRAISAL	MethodOfDeterminingRevenues

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	565765	NoncashContribsRptdF990
Method Of Determining Revenues	COST OF DONATED PROPERTY	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
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 OPENED THE PRAIRIE CENTER ON ITS MAIN CAMPUS IN THE FALL OF 2010. THIS FIVE-STORY, 260,000-SQUARE-FOOT FACILITY IS HOME TO THE AVERA CANCER INSTITUTE AND AVERA SURGERY CENTER. THE AVERA CANCER INSTITUTE IS A COMPREHENSIVE HEALING ENVIRONMENT, WITH VIRTUALLY ALL CANCER SERVICES PROVIDED UNDER ONE ROOF. PROGRAMS ARE DESIGNED TO SEE PATIENTS THROUGH THE ENTIRE REALM OF CANCER CARE FROM PREVENTION AND DIAGNOSIS TO VARIOUS TREATMENT MODES TO SURVIVORSHIP CARE. THE AVERA SURGERY CENTER IS AN OUTPATIENT SURGERY CENTER WITH EIGHT STATE-OF-THE-ART SURGICAL SUITES. THE DESIGN OFFERS THE CONVENIENCE AND AMENITIES OF A FREE-STANDING SURGICAL CENTER ALONG WITH THE BACKING PROVIDED BY A TERTIARY HOSPITAL. AVERA MCKENNAN EXPANDED OUR OWNED SPECIALTY CLINIC OFFERINGS TO INCLUDE ORTHOPEDICS AND OPHTHALMOLOGY.
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 2011, SERVICES PROVIDED TO THOSE WHO ARE UNABLE TO PAY TOTALED $25,687,000, 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. ACCESSIBILITY TO HEALTH CARE: AVERA MCKENNAN MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY IT SERVES. IN 2011 AVERA MCKENNAN HAD 20,647 HOSPITAL DISCHARGES, 107,713 PATIENT DAYS AND 205,850 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 24,719 EMERGENCY DEPARTMENT VISITS IN FY 2011. 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 1,371 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 733 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 8,794 VISITS IN FISCAL YEAR 2011. RESIDENCY/HEALTH PROFESSIONS TRAINING AND INTERNSHIPS: IN 2011, AVERA MCKENNAN HAD 80 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 40 UNPAID INTERNSHIPS IN 2011 IN THE AREAS OF MARKETING, HUMAN RESOURCES, FOUNDATION, NETWORK OPERATIONS AND PROCESS EXCELLENCE, WORKING WITH APPROXIMATELY 22 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 2011, VIDEOS OF THESE PRESENTATIONS WERE VIEWED 583 TIMES ONLINE. - 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 2011, 179 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 975 ATTENDEES. A TOTAL OF 39 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 693 ATTENDEES. A TOTAL OF 211 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 2,869 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 38 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 2011, THE MEDICAL CALL CENTER HANDLED 62,472 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 NO QUALIFY FOR MEDICAID, BUT CANNOT AFFORD HEALTH INSURANCE. THE PROGRAM OFFERS PRENATAL CARE, AND HOSPITAL LABOR AND DELIVERY FOR A LOW FEE OF $950. 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 2011, AVERA MCKENNAN ASSISTED WITH 93 BIRTHS AND PROVIDED 664 PRENATAL AND POST-PARTUM VISITS.
		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 2011 THE WALSH FAMILY VILLAGE SERVED 7,063 GUESTS, STAYING IN 3,593 NIGHTLY ROOMS. SUPPORT OF INDIAN RESERVATIONS: IN 2011, AVERA MCKENNAN DELIVERED THREE TRUCKLOADS OF EXCESS MEDICAL EQUIPMENT, FURNITURE, CLOTHING AND SUPPLIES TO INDIAN RESERVATIONS IN SOUTH DAKOTA. WITH TRUCK RENTAL AND FUEL EXPENSE, EACH TRIP COST APPROXIMATELY $1,000 IN ADDITION TO THE DONATIONS. 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. 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 $2,368,472 IN 2011. PRESCHOOL VISION AND HEARING SCREENING: AVERA MCKENNAN PROVIDED FREE SCREENING FOR 336 PRESCHOOL CHILDREN IN FISCAL YEAR 2011.
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 2011, CHARITY AND UNCOMPENSATED CARE PROVIDED BY RURAL HOSPITALS TOTALED $546,000, BASED ON CHARGES FOREGONE. 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 2011 RURAL HOSPITALS HAD 1,971 DISCHARGES, 7,899 PATIENT DAYS AND 58,134 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 2011, CHARITY AND UNCOMPENSATED CARE PROVIDED BY CLINICS TOTALED $1,275,000, BASED ON CHARGES FOREGONE. 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 2011, AVERA DONATED APPROXIMATELY 80 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 THREE FREE HEALTH SCREENINGS IN 2011 INCLUDING A SKIN CANCER SCREENING IN COOPERATION WITH ANOTHER LOCAL HOSPITAL AND PHARMACY, SERVING 151 PERSONS; AND MEN'S AND WOMEN'S HEALTH SCREENINGS, PROVIDING FREE CHOLESTEROL, BLOOD SUGAR, BLOOD PRESSURE AND BODY-MASS INDEX SCORING. THESE SCREENINGS SERVED 105 MEN AND 85 WOMEN.
FORM 990, PART VI, SECTION A, LINE 2		GENE JONES JR., CINDY WALSH, AND FRED THURMAN - BUSINESS RELATIONSHIP DAVE STRAND MD AND BRAD THAEMERT MD - BUSINESS RELATIONSHIP TOM DEMPSTER, FRED SLUNECKA, 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 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.
FORM 990, PART VI, SECTION A, LINE 7A		AVERA HEALTH, AS THE SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B		AVERA HEALTH HAS THE FOLLOWING RIGHTS AS THE MEMBER: 1) TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE STATEMENTS OF PHILOSOPHY, MISSION AND VALUES OF CORPORATION; 2) TO INITIATE THE ADOPTION, AMENDMENT OR REPEAL OF ANY PROVISION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CORPORATION, AND TO GIVE FINAL APPROVAL OF ANY SUCH ACTION WITH RESPECT THERETO; 3) TO APPROVE AND ACT UPON THE ALIENATION OF REAL PROPERTY AND PRECIOUS ARTIFACTS UNDER THE CANONICAL STEWARDSHIP OF THE SISTERS OF THE PRESENTATION OF THE BLESSED VIRGIN MARY OF ABERDEEN, SOUTH DAKOTA ("PRESENTATION SISTERS") OR THE BENEDICTINE SISTERS OF SACRED HEART MONASTERY ("BENEDICTINE SISTERS"), PURSUANT TO THE POLICIES ESTABLISHED BY THE MEMBER; 4) TO APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION, OR THE DIVESTITURE OF A SPONSORED WORK OR MINISTRY ASSOCIATED WITH THE CORPORATION; 5) TO APPROVE THE CREATION OF NEW SPONSORED WORKS OR MINISTRIES TO BE CONDUCTED BY OR UNDER THE AUTHORITY OF THE CORPORATION; 6) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE BOARD OF DIRECTORS OF THE CORPORATION. 7) TO APPOINT AND/OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION. 8) TO APPROVE OPERATING/CAPITAL BUDGETS AND STRATEGIC PLANS OF THE CORPORATION. 9) TO APPROVE EXPENDITURES OUTSIDE OF OPERATING AND CAPITAL BUDGETS EXCEEDING DEFINED THRESHOLDS ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 10) TO APPROVE ACQUISITIONS, SALES AND LEASES, ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 11) TO ESTABLISH AND MAINTAIN EMPLOYEE BENEFIT PROGRAMS. 12) TO ESTABLISH AND MAINTAIN INSURANCE PROGRAMS. 13) TO APPROVE MAJOR COMMUNITY FUND DRIVES. 14) TO APPROVE THE APPOINTMENT OF AUDITORS. 15) TO ADOPT POLICIES DESIGNED TO EFFECTUATE THE RESERVED POWERS OF THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11		FORM 990 IS REVIEWED BY THE CEO, CFO AND DIRECTOR OF FINANCIAL REPORTING. AFTER THE INITIAL REVIEW, A DRAFT IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW. THE 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 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 ANOTHER RELATED ORGANIZATION, AVERA MARSHALL.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 15,424,833. BOOK/TAX ADJUSTMENTS ON PARTNERSHIPS -4,060,453. EQUITY TRANSFERS, NET -699,541. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,346,111. INCOME FROM GRANTOR TRUST NOT INCLUDED ON FINANCIAL STATEMENTS 366,789. LOSS ON RETIREMENT OF DEBT -253,242. CHANGE IN ACCOUNTING PRINCIPLES -1,918,602. OTHER CHANGES IN NET ASSETS 318,029. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP DESIGNATED AS HEDGE -718,740. STEP UP BASIS OF ASSETS FROM ACQUISITION OF HEART HOSPITAL OF SOUTH DAKOTA 5,083,056. CHANGE IN NONCONTROLLING INTEREST OF HEART HOSPITAL OF SOUTH DAKOTA LLC 156,901. TOTAL TO FORM 990, PART XI, LINE 5: 15,045,141.
	FORM 990, PART XII, LINE 2C	THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA MCKENNAN. ALSO, THE FINANCE COMMITTEE AT AVERA MCKENNAN TAKES RESPONSIBILITY FOR REVIEWING THE AUDITED FINANCIAL STATEMENTS.
	FORM 990, PART VI, LINE 16B	THERE IS NO WRITTEN POLICY OR PROCEDURE SINCE IN THE EVENT OF ANY SUCH PROPOSED TRANSACTION THE BOARD OR A COMMITTEE WITH DELEGATED AUTHORITY REVIEWS ALL MATERIALS, VALUATIONS AND OPERATIONAL ASPECTS FOR ANY PROPOSED TRANSACTION. SUCH TRANSACTION WOULD BE EVALUATED IN ACCORDANCE WITH THE EXEMPT STATUS OF THE ORGANIZATION AND ITS APPLICABLE PURPOSES. ANY TRANSACTION ALSO WOULD BE APPROVED BY THE BOARD AND THE MEMBER.
	FORM 990, PART X, LINE 20	THE ISSUE PRICE INCLUDES THE FILING ORGANIZATION'S SHARE OF THE ENTIRE BOND ISSUE, WHICH WAS ISSUED TO AVERA HEALTH ON BEHALF OF THE AVERA OBLIGATED GROUP. THE AVERA OBLIGATED GROUP CONSISTS OF AVERA MCKENNAN, AVERA ST. LUKE'S, AVERA QUEEN OF PEACE, AND AVERA SACRED HEART. IN ACCORDANCE WITH IRS INSTRUCTIONS, INFORMATION RELATED TO THE TAX EXEMPT BOND REPORTING IS BEING REPORTED ON AVERA HEALTH'S TAX RETURN (EIN 46-0422673).

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 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	Direct Controlling Entity NADirectControllingEntityNA
SIOUX FALLS HOSPITAL MANAGMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	562141521	MANAGEMENT COMPANY OF HEART HOSPITAL	NC	0	6415591	WEST 69TH STREET LLC
WEST 69TH STREET LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045		HOLDING COMPANY	SD	0	6415591		N/A

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 (11 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Business Name Line1DirectControllingEntityName/BusinessNameLine1
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	460488198	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A	RELATED	587510	4759475	1	$152,794	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	N/A	RELATED	-131935	1312577	0		1	0.51000
MERSCO MEDICAL OF PIERRE LLC
329 E DAKOTA	PIERRE	SD	57501	460444002	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A	RELATED	67242	234584	0	$17,030	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		RELATED	22791	86468	1	$5,953	1	0.39320	AVERA HOME MEDICAL EQUIPMENT LLC
AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC
PO BOX 5045	SIOUX FALLS	SD	57117	201686097	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		RELATED	27191	135786	1	$7,837	1	0.39320	AVERA HOME MEDICAL EQUIPMENT LLC
AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC
38 19TH ST SW	SIOUX CENTER	IA	51250	753203100	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		RELATED	33944	93068	1	$11,817	1	0.39320	AVERA HOME MEDICAL EQUIPMENT LLC
AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC
1104 EAST COLLEGE DRIVE	MARSHALL	MN	56258	205271924	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		RELATED	68864	220928	1	$19,737	1	0.39320	AVERA HOME MEDICAL EQUIPMENT LLC
Q&M PROPERTIES LLC
525 NORTH FOSTER	MITCHELL	SD	57301	731652049	MEDICAL CLINIC BUILDING	SD		RELATED	-15277	426344	0		0	0.50000	AVERA QUEEN OF PEACE
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA ST	ABERDEEN	SD	57401	460461429	SURGICAL ASSOCIATES	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVENUE 102	SIOUX FALLS	SD	57117	800619999	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		RELATED	-51943	63503	1	-$28,446	1	0.39320	AVERA HOME MEDICAL EQUIPMENT LLC
HEART HOSPITAL OF SOUTH DAKOTA LLC
10720 SIKES PLACE SUITE 300	CHARLOTTE	NC	28277	562143771	HEALTHCARE SERVICES	NC	N/A	RELATED	2718435	24740500	1		1	0.66670

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 (13 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
AVERA HOME MEDICAL EQUIPMENT LLC
A	304740	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
K	104849	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
K	134743	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
Q	219069	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
Q	4367477	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
R	577079	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
R	4684842	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
R	1753245	INTERCOMPANY DETAIL FROM GL
MIDWEST REGIONAL IMAGING SERVICES LLC
C	3774357	INTERCOMPANY DETAIL FROM GL
AVERA HOME MEDICAL EQUIPMENT LLC
C	427350	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
C	11428310	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
K	924680	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
Q	474158	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