SACRED HEART HEALTH SERVICES: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: SACRED HEART HEALTH SERVICES (EIN 46-0225483)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-05-15
IRS object ID: 201231369349303438
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 K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-15T13:23:43-05:00	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	460225483	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SACRED HEART HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SACR	NameControl
Phone	6056688000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT STREET	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PAMELA J REZAC	Name
Title	CEO	Title
Phone	6056688000	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

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	AVERA SACRED HEART HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PAMELA J REZAC	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT STREET	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	104146553	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.AVERASACREDHEART.COM	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	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	1022	TotalNbrEmployees
Total Nbr Volunteers	338	TotalNbrVolunteers
Total Gross UBI	50687	TotalGrossUBI
Net Unrelated Business Txbl Income	48952	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	537621	ContributionsGrantsPriorYear
Contributions Grants Current Year	580917	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	86234554	ProgramServiceRevenuePriorYear
Program Service Revenue CY	98322426	ProgramServiceRevenueCY
Investment Income Prior Year	1942062	InvestmentIncomePriorYear
Investment Income Current Year	4477513	InvestmentIncomeCurrentYear
Other Revenue Prior Year	-371345	OtherRevenuePriorYear
Other Revenue Current Year	-195948	OtherRevenueCurrentYear
Total Revenue Prior Year	88342892	TotalRevenuePriorYear
Total Revenue Current Year	103184908	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	70550	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	877341	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	43438643	SalariesEtcPriorYear
Salaries Etc Current Year	49947165	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	100428	TotalFundrsngExpCurrentYear
Other Expense Prior Year	37746072	OtherExpensePriorYear
Other Expenses Current Year	41312851	OtherExpensesCurrentYear
Total Expenses Prior Year	81255265	TotalExpensesPriorYear
Total Expenses Current Year	92137357	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	7087627	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	11047551	RevenuesLessExpensesCY
Total Assets BOY	207545147	TotalAssetsBOY
Total Assets EOY	230597519	TotalAssetsEOY
Total Liabilities BOY	27518006	TotalLiabilitiesBOY
Total Liabilities EOY	33570247	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	180027141	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	197027272	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	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	76443147	Expense
Grants	877341	Grants
Revenue	98271739	Revenue
Description	AVERA SACRED HEART HOSPITAL (SACRED HEART HEALTH SERVICES) LEADS DELIVERY OF HEALTHCARE TO ITS REGION THROUGH OVER 1,000 EMPLOYEES (AS WELL AS 62 PHYSICIANS ON ITS ACTIVE MEDICAL STAFF) WHICH COORDINATE CARE TO DELIVER PATIENT CARE AS AN INTEGRATED UNIT. AVERA SACRED HEART AND ITS AFFILIATES (REFERRED TO COLLECTIVELY AS SACRED HEART HEALTH SERVICES) ALSO WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE IN SOUTHEAST SOUTH DAKOTA AND NORTHEAST NEBRASKA. IN ADDITION TO THE 144 BED HOSPITAL, AVERA SACRED HEART INCLUDES TWO NURSING HOMES AND A CONGREGATE HOUSING FACILITY, AND A 23-BED CRITICAL ACCESS HOSPITAL, LONG-TERM CARE FACILITY, AND 2 CLINICS IN CREIGHTON, NE. IT ALSO MANAGES THREE HOSPITALS AND TWO NURSING HOMES. AVERA SACRED HEART OPERATES UNDER THE TENETS OF THE ROMAN CATHOLIC CHURCH AND IN ACCORDANCE WITH THE PHILOSOPHY AND VALUES ESTABLISHED FOR AVERA HEALTH, A SPONSORED HEALTH MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS. AVERA SACRED HEART ENGAGES IN ACTIVITIES DESIGNED TO IMPROVE THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES THAT IT SERVES IN RESPONSE TO A CALLING TO HEAL THE SICK, THE ELDERLY AND THE OPPRESSED.REQUIREMENTS OF THE IRS COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT ORGANIZATIONS ARE INTEGRAL TO AVERA SACRED HEART HOSPITAL'S LARGER CHARITABLE MISSION OF IMPROVING HEALTH AND QUALITY OF LIFE. SPECIFICALLY, AVERA SACRED HEART IS GOVERNED BY AN INDEPENDENT BOARD INCLUDING COMMUNITY LEADERS, BUSINESS AND CLINICAL HEALTHCARE EXPERTS. THE BOARD HAS A HISTORY OF COMMITMENT TO ACT WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES FOR THE BENEFIT OF THE COMMUNITY. AVERA SACRED HEART MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY IT SERVES REGARDLESS OF ABILITY TO PAY, OF WHICH THERE WERE 15,042 HOSPITAL PATIENT DAYS AND 67,556 NURSING HOME RESIDENT DAYS IN FY '11. AVERA SACRED HEART HOSPITAL WAS NAMED BY HEALTHGRADES AS ONE OF THE TOP 10% HOSPITALS IN THE NATION FOR PROVIDING AN OUTSTANDING PATIENT EXPERIENCE. AVERA SACRED HEART OPERATES A FULL-TIME EMERGENCY DEPARTMENT, WHICH PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. IN FY '11, THERE WERE 10,418 VISITS. AVERA SACRED HEART PROVIDES CLINICAL SERVICES NEEDED TO OPERATE THE EMERGENCY CENTER AND PROVIDES ON-SITE EMERGENCY MEDICAL, RESCUE AND MEDICAL TRANSPORTATION SERVICES. IN ADDITION, AVERA SACRED HEART, THROUGH ITS INTEGRATED NETWORK OF PROVIDERS, PROVIDES NON-EMERGENCY SERVICES TO THE COMMUNITY IT SERVES. IT MAKES THESE SERVICES ACCESSIBLE TO THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT PROGRAMS LIKE MEDICARE AND MEDICAID, REGARDLESS OF ABILITY TO PAY. AVERA SACRED HEART'S CHARITY CARE POLICY PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE CHARITY CARE POLICY IS DESIGNED TO ENSURE THE ENTIRE COMMUNITY SERVED BY AVERA SACRED HEART HAS ACCESS TO NEEDED HEALTHCARE SERVICES. THE AVERA SACRED HEART BOARD OF DIRECTORS OVERSEES SERVICES DELIVERED UNDER THE CHARITY CARE POLICY INCLUDING ASSESSING COMMUNITY NEEDS, APPROVING ELIGIBILITY CRITERIA AND MONITORING THE EFFECTIVENESS OF THE PROGRAM IN PROVIDING COMMUNITY ACCESS TO MEDICAL CARE.ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME LEVELS AND FAMILY SIZE. IN ADDITION, AN AUTOMATIC DISCOUNT OFF CHARGES IS PROVIDED TO ANY PATIENT THAT IS DETERMINED TO NOT HAVE INSURANCE OF ANY TYPE. APPLICATIONS FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY AVERA SACRED HEART PATIENT REGISTRATION AREA OR BY CALLING THE AVERA SACRED HEART BUSINESS OFFICE.AVERA SACRED HEART MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE PROVIDED UNDER THE CHARITY CARE POLICY. AVERA SACRED HEART HAD CHARGES FOREGONE FOR CHARITY FOR THE YEAR ENDED JUNE 30, 2011 OF APPROXIMATELY $2,318,730.AVERA SACRED HEART TAKES ITS MISSION TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IT SERVES A STEP FURTHER BY REACHING OUT TO MEET THE BROAD HEALTH NEEDS OF THE COMMUNITY. IT STRIVES TO IDENTIFY COMMUNITY NEEDS BEYOND BASIC HEALTH CARE, RESPOND TO THEM, AIMING TO MAKE A POSITIVE, LIFE-ENHANCING DIFFERENCE IN THE COMMUNITY. AVERA SACRED HEART TAKES A STRATEGIC, COMMUNITY NEEDS-BASED APPROACH TO DELIVERING BENEFITS TO THE COMMUNITY. AVERA SACRED HEART HOSPITAL DEMONSTRATES ITS COMMITMENT TO PROVIDING COMMUNITY BENEFIT THROUGH SPECIFIC ACCOMPLISHMENTS:E-TECHNOLOGY: AVERA SACRED HEART STARTED WITH ITS EICU PROGRAM FOUR YEARS AGO. EICU IS A TELEMEDICINE-BASED SYSTEM THAT AIDS IN THE CARE OF ICU PATIENTS AT AVERA SACRED HEART AND ACROSS THE AVERA SYSTEM. PATIENTS RECEIVE CONSTANT, AROUND-THE-CLOCK MONITORING AND INTERVENTIONS FROM A REMOTE CARE TEAM IN ADDITION TO THE CARE THEY RECEIVE FROM THEIR BEDSIDE TEAM. IN ADDITION, AVERA SACRED HEART HOSPITAL, ALONG WITH AVERA ST. ANTHONY, AVERA CREIGHTON, ST. MICHAEL'S HOSPITAL/AVERA AND WAGNER COMMUNITY MEMORIAL HOSPITAL/AVERA, HAS LAUNCHED AN ESTROKE PROGRAM THAT WILL ENABLE PATIENTS SUFFERING STROKES TO BE MORE QUICKLY DIAGNOSED AND TREATED THROUGH THE USE OF TELEMEDICINE. AVERA HAS ALSO IMPLEMENTED AN EPHARMACY PROGRAM WHERE FACILITIES WITHOUT 24 HOUR A DAY PHARMACIST COVERAGE CAN ACCESS PHARMACIST SERVICES REMOTELY.TEACHING HOSPITAL: AVERA SACRED HEART IS A TEACHING HOSPITAL, WHICH REFLECTS A STRONG COMMITMENT TO EDUCATION, RESEARCH AND A HIGH LEVEL OF CARE. IN THE SUMMER OF 2007, THE HOSPITAL OPENED THE NEW AVERA PROFESSIONAL OFFICE PAVILION & EDUCATION CENTER TO ENHANCE THEIR COMMITMENT TO MEDICAL EDUCATION. THE AVERA PAVILION IS THE NEW HOME OF THE UNIQUE YANKTON AMBULATORY PROGRAM FOR THE THIRD-YEAR MEDICAL STUDENTS OF THE SANFORD SCHOOL OF MEDICINE OF THE UNIVERSITY OF SOUTH DAKOTA. THE PROGRAM CHALLENGES MEDICAL STUDENTS TO SOLVE CLINICAL PROBLEMS AND EXPERIENCE THE DOCTOR-PATIENT RELATIONSHIP THROUGH THE YEAR. YANKTON IS ONLY ONE OF THREE COMMUNITIES IN THE STATE WHERE A CAMPUS IS PROVIDED FOR THE SANFORD SCHOOL OF MEDICINE. THE OFFICE FOR THE DEAN OF THE YANKTON AMBULATORY PROGRAM OF THE AVERA SACRED HEART YANKTON CAMPUS IS NOW LOCATED ON THE FIRST FLOOR OF THE PAVILION. STUDY SPACE FOR THE MEDICAL STUDENTS IS ADJACENT TO THE ASHH MEDICAL LIBRARY. A UNIQUE COMPONENT TO THE PAVILION IS THE EXPANSION AND ENHANCEMENT OF EDUCATIONAL FACILITIES. ALONG WITH A 116-SEAT AUDITORIUM, THERE ARE ALSO THREE CONFERENCE ROOMS, ALL EQUIPPED WITH THE LATEST IN AUDIOVISUAL TECHNOLOGY.RESIDENCY/HEALTH PROFESSIONS TRAINING: AT ANY ONE TIME, 10 TO 15 SANFORD SCHOOL OF MEDICINE OF THE UNIVERSITY OF SOUTH DAKOTA MEDICAL STUDENTS ARE IN TRAINING AT AVERA SACRED HEART HOSPITAL. IN ADDITION, STUDENTS IN NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, RADIOLOGY AND RESPIRATORY THERAPY ALSO AFFILIATE HERE. AVERA SACRED HEART ALSO HAS A RADIOLOGY TECHNOLOGIST SCHOOL, WHICH GRADUATES 6 TO 8 NEW RADIOLOGY TECHNOLOGISTS EACH YEAR. PREVENTIVE CARE A PRIORITY: AVERA SACRED HEART HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES THROUGH THE MANY EDUCATIONAL PROGRAMS, HEALTH SCREENINGS AND FAIRS THAT ARE HELD THROUGHOUT THE YEAR. AVERA SACRED HEART HOLDS SCREENINGS THROUGHOUT THE REGION AT THEIR RURAL HEALTH CLINICS AS WELL AS IN YANKTON. THE HOSPITAL IS NOW CONNECTED TO THE ASK-A-NURSE PROGRAM THAT PROVIDES GENERAL INFORMATION CONCERNING HEALTH-RELATED TOPICS. OUR WEB SITE INCORPORATES THE "ADAM" SOFTWARE THAT PROVIDES A UNIQUE LEVEL OF HEALTH-RELATED INFORMATION TO THE CONSUMER. IN 2009, AVERA SACRED HEART HOSPITAL INTRODUCED PLANET HEART (IN CONJUNCTION WITH THE AVERA HEART HOSPITAL) AND AN IN-HOUSE CARDIOVASCULAR SCREENING PACKAGE TO KEEP THE PEOPLE WE SERVED BETTER INFORMED ABOUT THEIR HEALTH. BASED ON COMMUNITY NEEDS, WE ARE CONTINUALLY STRIVING TO PROVIDE MORE PREVENTATIVE TOOLS AND RISK ASSESSMENTS TO OUR POPULATION.(CONTINUED ON PAGE 9 OF SCHEDULE O)	Description
Total Program Service Expense	76443147	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	1	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	0	ProfessionalFundraising
Fundraising Activities	1	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	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	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	119	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1022	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	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
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	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	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	0	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	JAMIE A SCHAEFER	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6056688776	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (22 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	FormerFormer
AMY FREEBURG
CHAIR	2.00	X	X	0	0	0
ROB STEPHENSON
VICE CHAIR	2.00	X	X	0	0	0
MICHAEL PIETILA
BOARD MEMBER	2.00	X		0	0	0
SR MARY KAY PANOWICZ
BOARD MEMBER	2.00	X		0	0	0
SR CORRINE LEMMER
BOARD MEMBER	2.00	X		0	0	0
BRAD DYKES
BOARD MEMBER	2.00	X		0	0	0
JOHN NAGENGAST
BOARD MEMBER	2.00	X		0	0	0
MICHAEL SCHURRER
BOARD MEMBER/PHYSICIAN	40.00	X		268775	0	72131
MARTY JANS
BOARD MEMBER	2.00	X		0	0	0
SR LUCILLE WELBIG
BOARD MEMBER	2.00	X		0	0	0
SR LYNN MARIE WELBIG
BOARD MEMBER	2.00	X		0	0	0
MARY PAT BIERLE
BOARD MEMBER	2.00	X		0	0	0
PAMELA J REZAC
PRESIDENT & CEO	60.00	X	X	0	469679	29676
DAVID A TIMPE
SEC/TREAS & VP FINANCE-THRU 8/10	52.00		X	89856	0	20480
JAMIE A SCHAEFER
SEC/TREAS & VP FINANCE	52.00		X	64905	0	11434
DOUGLAS EKEREN
VP NETWORK SERVICES	52.00			172619	0	44000	X
MICHAEL PETERSON
PHYSICIAN	40.00			494674	0	68321		X
BARRY A GRAHAM
VP MEDICAL AFFAIRS (PHYSIC	40.00			230245	0	54048		X
STEVE GUTNIK
PHYSICIAN	40.00			564583	0	33316		X
SCOTT HILTUNEN
PHYSICIAN	40.00			241815	0	40821		X
GREGORY ERICKSON
PHYSICIAN	40.00			240468	0	24297		X
BARBARA LARSON
FORMER KEY EMPLOYEE - VP PATIENT CARE SERVICES	52.00			129076	0	62933			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2497016	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	469679	TotalReportableCompFrmRltdOrgs
Total Other Compensation	461457	TotalOtherCompensation
Number Individuals GT100 K	34	NumberIndividualsGT100K
Formers Listed	1	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
YANKTON ANESTHESIOLOGY PC
1000 W 4TH ST SUITE 13	YANKTON	SD	57078	ANESTHESIOLOGISTS	1448334
MEDICUS RADIOLOGY SERVICE
7 INDUSTRIAL WAY UNIT 5	SALEM	NH	03079	LOCUM RADIOLOGISTS	691105
YANKTON MEDICAL CLINIC PC
PO BOX 706	YANKTON	SD	57078	MEDICAL DIRECTORS	308707
ASSOCIATED REGIONAL & UNIVERSITY
PO BOX 27964	SALT LAKE CITY	UT	84127	PATHOLOGY	247127
PHYSICIANS LABORATORY LTD
PO BOX 5050	SIOUX FALLS	SD	571175050	REFERENCE LAB	200819

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	8	NumberOfContractorsGT100K
Fundraising Events	30561	FundraisingEvents
Related Organizations	30000	RelatedOrganizations
All Other Contributions	520356	AllOtherContributions
Noncash Contributions	124265	NoncashContributions
Total Contributions	580917	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE RE	622110	95589485	95589485
NONMEDICAL OUTREACH	900099	1684685	1684685
OTHER REVENUE	900099	765654	765654
INCOME FROM AFFILIATES	900099	282602	231915	50687

Field	Value	IRS element (for citing)
Total Program Service Revenue	98322426	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1540041	TotalRevenueColumn
Exclusion	$1,540,041	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	335355	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	714038	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-378683	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-378683	TotalRevenueColumn
Exclusion	-$378,683	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	3173723	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	236251	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	3173723	Securities
Other	-236251	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	2937472	TotalRevenueColumn
Exclusion	$2,937,472	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	25564	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	30561	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	11356	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	14208	TotalRevenueColumn
Exclusion	$14,208	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	INTEREST INCOME	Description
Business Code	900099	BusinessCode
Total Revenue Column	168527	TotalRevenueColumn
Exclusion	$168,527	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	168527	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	103184908	TotalRevenueColumn
Related Or Exempt Function Income	98271739	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	50687	UnrelatedBusinessRevenue
Exclusion	$4,281,565	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	877341	Total
Program Services	877341	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	729342	Total
Program Services	347634	ProgramServices
Management And General	381708	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	187712	Total
Management And General	187712	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	39967701	Total
Program Services	33704463	ProgramServices
Management And General	6182293	ManagementAndGeneral
Fundraising	80945	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	967079	Total
Program Services	824418	ProgramServices
Management And General	140653	ManagementAndGeneral
Fundraising	2008	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	5681778	Total
Program Services	4771054	ProgramServices
Management And General	899251	ManagementAndGeneral
Fundraising	11473	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2413553	Total
Program Services	2013145	ProgramServices
Management And General	395581	ManagementAndGeneral
Fundraising	4827	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	8096	Total
Management And General	8096	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	55558	Total
Management And General	55558	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	10320116	Total
Program Services	5889963	ProgramServices
Management And General	4430153	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	641643	Total
Program Services	40263	ProgramServices
Management And General	601380	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	6337241	Total
Program Services	5343076	ProgramServices
Management And General	994165	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	26128	Total
Program Services	1340	ProgramServices
Management And General	24788	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2187484	Total
Program Services	1859268	ProgramServices
Management And General	328216	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	430319	Total
Program Services	319156	ProgramServices
Management And General	111163	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	514573	Total
Program Services	186618	ProgramServices
Management And General	327955	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	783036	Total
Program Services	783036	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	7225439	Total
Program Services	7225439	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	761117	Total
Program Services	760782	ProgramServices
Management And General	335	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	9014471	9014471
BAD DEBT	1997270	1997270
EQUIPMENT LEASE AND REN	328095	193902	134193
LICENSES AND PERMITS	94399	72694	21705
PROVISION FOR INCOME TA	52656	52656

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	535210	Total
Program Services	165158	ProgramServices
Management And General	368877	ManagementAndGeneral
Fundraising	1175	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	92137357	Total
Program Services	76443147	ProgramServices
Management And General	15593782	ManagementAndGeneral
Fundraising	100428	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	297909	BOY
EOY	472988	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	7643	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	11131387	BOY
EOY	17893469	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	818832	BOY
EOY	1375571	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	227877	BOY
EOY	562347	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	133050122	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	77780959	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	49232842	BOY
EOY	55269163	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	12618837	BOY
EOY	9234176	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	131742487	BOY
EOY	143519679	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	546969	BOY
EOY	797178	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	632157	BOY
EOY	640839	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	295850	BOY
EOY	824466	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	207545147	BOY
EOY	230597519	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	8429251	BOY
EOY	10576171	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	484638	BOY
EOY	909526	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	15665427	BOY
EOY	18707968	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
EOY	15732	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2938690	BOY
EOY	3360850	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	27518006	BOY
EOY	33570247	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	168717932	BOY
EOY	184247593	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	10852413	BOY
EOY	12321763	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	456796	BOY
EOY	457916	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	180027141	BOY
EOY	197027272	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	207545147	BOY
EOY	230597519	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	11047551	ReconcilationRevenueExpenses
Reconcilation Other Changes	5952580	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$31,717	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	31717	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtc
Included On FS	1	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	716457	BeginningOfYearBalance
Contributions	1120	Contributions
Investment Earnings Or Losses	87570	InvestmentEarningsOrLosses
Other Expenditures	4083	OtherExpenditures
End Of Year Balance	801064	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	676350	BeginningOfYearBalance
Contributions	540	Contributions
Investment Earnings Or Losses	41680	InvestmentEarningsOrLosses
Other Expenditures	2113	OtherExpenditures
End Of Year Balance	716457	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	721018	BeginningOfYearBalance
Contributions	11570	Contributions
Investment Earnings Or Losses	-18197	InvestmentEarningsOrLosses
Other Expenditures	38041	OtherExpenditures
End Of Year Balance	676350	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	0.57160	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.42840	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3455133	OtherCostOrOtherBasis
Book Value	3455133	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	84330223	OtherCostOrOtherBasis
Depreciation	47529719	Depreciation
Book Value	36800504	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	38775438	OtherCostOrOtherBasis
Depreciation	27113203	Depreciation
Book Value	11662235	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6489328	OtherCostOrOtherBasis
Depreciation	3138037	Depreciation
Book Value	3351291	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	55269163	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS	142467130	F
INVESTMENT IN AFFILIATED ORGANIZATION	1052549	C

Field	Value	IRS element (for citing)
Total Of Book Value Securities	143519679	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$2,950,000
MARKET VALUE OF INTEREST RATE SWAP	$410,850

Field	Value	IRS element (for citing)
Total Of Amounts	3360850	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART IV, LINE 2B:	RESIDENT TRUST FUNDS ARE HELD ON BEHALF OF THE RESIDENTS.
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENT REPRESENTS DONOR-RESTRICTED ENDOWMENT FUNDS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS.	DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X:	THE ORGANIZATION HAS IMPLEMENTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION TOPIC 740-10 (FORMERLY FINANCIAL INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES). THE ORGANIZATION UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY ASC 740-10. FOR THE YEARS ENDED JUNE 30, 2010 AND 2009, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SIMPLY D'VINE	NameOfEvent1
Gross Receipts Event1	56125	GrossReceiptsEvent1
Charitable Contributions Event1	38561	CharitableContributionsEvent1
Gross Revenue Event1	17564	GrossRevenueEvent1
Non Cash Prizes Event1	477	NonCashPrizesEvent1
Rent Facility Costs Event1	7241	RentFacilityCostsEvent1
Food And Beverage Event1	2538	FoodAndBeverageEvent1
Entertainment Event1	1100	EntertainmentEvent1
Gross Receipts Total	56125	GrossReceiptsTotal
Charitable Contributions Total	38561	CharitableContributionsTotal
Gross Revenue Total Events	17564	GrossRevenueTotalEvents
Non Cash Prizes Total Events	477	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	7241	RentFacilityCostsTotalEvents
Food And Beverage Total Events	2538	FoodAndBeverageTotalEvents
Entertainment Total Events	1100	EntertainmentTotalEvents
Direct Expense Summary Events	11356	DirectExpenseSummaryEvents
Net Income Summary	6208	NetIncomeSummary

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

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	150.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
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)
Number Of Activities Or Programs	1030	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	961428	TotalCommunityBenefitExpense
Net Community Benefit Expense	961428	NetCommunityBenefitExpense
Percent Of Total Expense	0.01070	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	16111704	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15206522	DirectOffsettingRevenue
Net Community Benefit Expense	905182	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1030	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	17073132	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15206522	DirectOffsettingRevenue
Net Community Benefit Expense	1866610	NetCommunityBenefitExpense
Percent Of Total Expense	0.02070	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1490	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	166015	TotalCommunityBenefitExpense
Direct Offsetting Revenue	35364	DirectOffsettingRevenue
Net Community Benefit Expense	130651	NetCommunityBenefitExpense
Percent Of Total Expense	0.00140	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	620	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	1257665	TotalCommunityBenefitExpense
Direct Offsetting Revenue	266158	DirectOffsettingRevenue
Net Community Benefit Expense	991507	NetCommunityBenefitExpense
Percent Of Total Expense	0.01100	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	10419	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	4832067	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4170387	DirectOffsettingRevenue
Net Community Benefit Expense	661680	NetCommunityBenefitExpense
Percent Of Total Expense	0.00730	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	40	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	42858	TotalCommunityBenefitExpense
Net Community Benefit Expense	42858	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	12569	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	6298605	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4471909	DirectOffsettingRevenue
Net Community Benefit Expense	1826696	NetCommunityBenefitExpense
Percent Of Total Expense	0.02020	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13599	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	23371737	TotalCommunityBenefitExpense
Direct Offsetting Revenue	19678431	DirectOffsettingRevenue
Net Community Benefit Expense	3693306	NetCommunityBenefitExpense
Percent Of Total Expense	0.04090	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	66645	TotalCommunityBuildingExpense
Net Community Building Expense	66645	NetCommunityBuildingExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	89267	TotalCommunityBuildingExpense
Net Community Building Expense	89267	NetCommunityBuildingExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	155912	TotalCommunityBuildingExpense
Net Community Building Expense	155912	NetCommunityBuildingExpense
Percent Of Total Expense	0.00170	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$854,597	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	24665414	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	26954746	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2289332	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	2	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Er24 HoursEr24Hours	Critical Access HospitalCriticalAccessHospital
AVERA SACRED HEART HOSPITAL
1	501 SUMMIT STREET	YANKTON	SD	57078	X	X	X
AVERA CREIGHTON HOSPITAL
2	1503 MAIN STREET	CREIGHTON	NE	68729	X	X	X	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	8	NumberOfOtherFacilities

Other Facilities OtherFacilities (8 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
AVERA YANKTON CARE CENTER
1212 W 8TH STREET	YANKTON	SD	57078	LONG TERM CARE
AVERA SISTER JAMES CARE CENTER
2111 W 11TH STREET	YANKTON	SD	57078	LONG TERM CARE
AVERA SACRED HEART MAJESTIC BLUFFS
2111 W 11TH STREET	YANKTON	SD	57078	ASSISTED LIVING
AVERA SACRED HEART HOSPITAL-REHAB UNIT
501 SUMMIT STREET	YANKTON	SD	57078	REHAB UNIT
AVERA CREIGHTON CARE CENTRE
1603 MAIN STREET	CREIGHTON	NE	687292999	LONG TERM CARE
AVERA SACRED HEART HOSPITAL-DIALYSIS
501 SUMMIT STREET	YANKTON	SD	57078	DIALYSIS UNIT
AVERA FOOT AND ANKLE
100 WEST 4TH ST	YANKTON	SD	57078	PROVIDER-BASED CLINIC
AVERA YANKTON EAR NOSE & THROAT
409 SUMMIT	YANKTON	SD	57078	PROVIDER-BASED CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanation
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: PART 1, LINE 6A: OUR COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY AVERA HEALTH, A RELATED ORGANIZATION. IT IS AVAILABLE THROUGH THE WEBSITE AND REQUESTED MAILING, AND IS FILED WITH THE CATHOLIC HEALTH ASSOCIATION.
PART I, LINE 7: CHARITY CARE AND UNREIMBURSED MEDICAID WAS CONVERTED TO COST USING THE COST TO CHARGE RATIO BASED ON PRIOR YEAR MEDICARE COST REPORT. UNREIMBURSED MEDICAID USES A COST TO CHARGE RATIO THAT INCLUDES OTHER ACTIVITIES BEYOND HOSPITAL INPATIENT. SUBSIDIZED HEALTH SERVICES WERE CONVERTED TO COST USING A COST TO CHARGE RATIO FOR THE MEDICARE COST REPORT FOR THE SPECIFIC PROGRAM. THE AMOUNTS ON LINES 7E-I REPRESENT EXPENSES REPORTED IN THE GENERAL LEDGER AND COMPILED USING CBISA SOFTWARE.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $1,997,270 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
PART II: THE ORGANIZATION IS ACTIVE IN RECRUITING PHYSICIANS TO YANKTON, SOUTH DAKOTA TO FULFILL HEALTH CARE NEEDS OF THE COMMUNITY. OTHER AMOUNTS REPORTED AS COMMUNITY BUILDING INCLUDE MONETARY AND IN-KIND DONATIONS TO COMMUNITY ORGANIZATIONS TO SUPPORT THE NEEDS OF THE COMMUNITY BEYOND THE NEED FOR HEALTHCARE. THESE CONTRIBUTIONS STRENGTHEN THE COMMUNITY BY FOCUSING ON UNDERLYING CAUSES OF HEALTH CARE ISSUES.
PART III, LINE 4: BAD DEBT WAS CONVERTED TO COST USING THE COST TO CHARGE RATIO DERIVED IN MEDICARE COST REPORT. 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: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, LINE 8: PART III, LINES 5, 6, AND 7: THE MEDICARE REVENUES RECEIVED (LINE 5), ALLOWABLE COSTS (LINE 6), AND THE RESULTING SHORTFALL (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 SACRED HEART HEALTH SERVICES. 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 NON-COST REPORT ENTITIES OPERATED BY SACRED HEART HEALTH SERVICES INCLUDE CLINICS, HOME MEDICAL EQUIPMENT STORE, 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, MARKETING, CRNA'S, AND INTEREST EXPENSE. IN ADDITION TO THESE DISALLOWED COSTS WITHIN THE HOSPITAL, SACRED HEART HEALTH SERVICES OPERATES CLINICS, HOME MEDICAL EQUIPMENT STORE, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES WHICH DO NOT FILE A COST REPORT. INCLUDING THE MEDICARE PERCENTAGE OF DISALLOWED COSTS, ENTITIES WHICH DON'T FILE A COST REPORT BUT NEVERTHELESS CARE FOR MEDICARE PATIENTS, AND THE IMPACT OF THE HOME OFFICE COST REPORT, THE MEDICARE SHORTFALL IS $6,720,726 AS OPPOSED TO A SHORTFALL OF $2,289,332.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. SACRED HEART HEALTH SERVICES FOLLOWS THE CHA GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL IS EXCLUDED FROM OUR COMMUNITY BENEFIT REPORT. HOWEVER, MEDICARE IS THE ORGANIZATION'S LARGEST PAYER AND PATIENTS WITH MEDICARE COVERAGE ARE ACCEPTED REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED FROM PROVIDING THE SERVICES. THIS BASIS THEREFORE MEANS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A KEY ADVANTAGE FOR OUR COMMUNITY.
PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. AT SUCH TIME AS THE ORGANIZATION SENDS THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY SHALL REFLECT THE REDUCED-PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. SACRED HEART HEALTH SERVICES DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES SACRED HEART HEALTH SERVICES UTILIZES MAY REPORT TO THE CREDIT AGENCIES. ANY EXTENDED PAYMENT PLANS OFFERED BY THE HOSPITAL, OR THE HOSPITAL'S REPRESENTATIVE, IN SETTLING THE OUTSTANDING BILLS OF PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
PART VI, LINE 2: AVERA SACRED HEART HOSPITAL INCLUDES COMMUNITY MEMBERS ON COMMITTEES, BOARDS AND ADVISORY GROUPS TO ALLOW COMMUNITY REACTION AND INPUT IN THE ACTIONS WE TAKE. WE ALSO REVIEW ALL DATA PROVIDED BY THE HEALTH DEPARTMENTS REGARDING DISEASE RATES, MORTALITY, MORBIDITY, POPULATION CHANGES, ETC. THE HOSPITAL ALSO CONDUCTS FOCUS GROUPS, CONSUMER PERCEPTION STUDIES, AND PATIENT SATISFACTION SURVEYS TO IDENTIFY PRIMARY NEEDS OF THE COMMUNITY AND RESPOND WITH PREVENTATIVE/EDUCATIONAL INFORMATION OR ACTIVITIES FOR THE COMMUNITY. THERE IS ONGOING PLANNING FOR A COMPREHENSIVE COMMUNITY NEEDS SURVEY WITH FOCUS GROUPS AND RAW DATA. THIS WAS IN PROCESS AS OF JUNE 30, 2011.
PART VI, LINE 3: THE BROCHURE "UNDERSTANDING YOUR HEALTH CARE BILLS" IS PROVIDED IN VISIBLE LOCATIONS EXPERIENCING HIGH VOLUMES OF INPATIENT OR OUTPATIENT REGISTRATIONS SUCH AS THE ADMITTING OFFICE, THE BILLING/BUSINESS OFFICE, AND EMERGENCY DEPARTMENT AS WELL AS THE ORGANIZATION WEBSITE. PATIENTS ARE ALSO MADE AWARE OF POSSIBLE ELIGIBILITY WHEN GIVEN THE "PATIENT RIGHTS AND RESPONSIBILIES" BROCHURE UPON ADMISSION. THE PATIENT ADVOCATE WORKS WITH UNINSURED/UNDERINSURED PATIENTS TO ENROLL THEM IN APPLICABLE SOCIAL SERVICE PROGRAMS AND/OR IDENTIFY CHARITY, COUNTY OR RISK POOL ELIGIBILITY.
PART VI, LINE 4: AVERA SACRED HEART HOSPITAL PRIMARILY SERVES THE CITY AND COUNTY OF YANKTON, SD AND THE SURROUNDING SOUTH DAKOTA COUNTIES OF BON HOMME, CHARLES MIX, CLAY AND HUTCHINSON, AND CEDAR COUNTY AND KNOX IN NEBRASKA. U.S CENSUS STATISTICS INDICATE THAT 8.7% OF THE CITY OF YANKTON'S INDIVIDUAL RESIDENTS FALL BELOW THE FEDERAL POVERTY GUIDELINES. FOR FY 2011, 45% OF OUR REVENUE CAME FROM MEDICARE AND MEDICARE ADVANTAGE PLANS, AND 11% CAME FROM MEDICAID.
PART VI, LINE 6: THE HOSPITAL BOARD IS COMPRISED OF INDIVIDUALS WHO REPRESENT THE INTERESTS OF THE COMMUNITY SERVED BY THE ORGANIZATION. THE HOSPITAL OFFERS STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SELECTED SERVICES SUCH AS RADIATION ONCOLOGY, DESIGNATED REHABILITATION UNIT, AND SWINGBED SERVICES WOULD NOT BE AVAILABLE IN OUR SERVICE AREA UNLESS PROVIDED BY THE ORGANIZATION. THE HOSPITAL SERVES ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING 24 HOUR A DAY EMERGENCY SERVICES. THE FACILITY PARTICIPATES IN THE EDUCATION OF MEDICAL STUDENTS FROM THE UNIVERSITY OF SOUTH DAKOTA THROUGH THEIR YANKTON LOCATION. THE HOSPITAL ALSO OFFERS A 2 -YEAR RADIATION TECHNOLOGIST PROGRAM THAT GRADUATES APPROXIMATELY 6 STUDENTS PER YEAR. SACRED HEART HOSPITAL ALSO PROVIDES CLINICAL EDUCATION FOR MOUNT MARTY COLLEGE STUDENTS. BOTH PROGRAMS ARE RECOGNIZED EDUCATION PROGRAMS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL IS ALSO PROUD OF THE FACT THAT 338 INDIVIDUALS CHOSE TO VOLUNTEER AT THE FACILITY DURING FY 2011.
PART VI, LINE 7: AVERA IS A SPONSORED MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS. THE COMMUNITIES IN WHICH AVERA HEALTH OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFITS NEEDS. IN KEEPING WITH CATHOLIC HEALTH ASSOCIATION GUIDELINES, EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE CORPORATE STAFF OF AVERA HEALTH ADVOCATES FOR ALL MEMBERS REGARDING COMMUNITY BENEFIT RELATED MATTERS OF STATE, REGIONAL AND NATIONAL IMPORTANCE.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AVERA HEALTH
3900 W AVERA DRIVE	SIOUX FALLS	SD	57108	460422673	501(C)(3)	24000	MEDICAL SCHOOL
MOUNT MARTY COLLEGE
1105 W 8TH ST	YANKTON	SD	57078	460283336	501(C)(3)	750000	NURSING SCHOOL EXPANSION
AVERA ST ANTHONY HOSPITAL FOUNDATION
300 N 2ND ST	ONEILL	NE	68763	470463911	501(C)(3)	20000	BUILDING PROJECT
UNIVERSITY OF SOUTH DAKOTA FOUNDATION
414 E CLARK	VERMILLION	SD	57069	466018891	501(C)(3)	50000	MEDICAL SCHOOL

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	4	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	4	NumberOfRecipients
Amount Of Cash Grant	20000	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 ORGANIZATION ONLY MAKES GRANTS TO OTHER ORGANIZATIONS WHICH ARE ALSO TAX-EXEMPT. THE ORGANIZATION ALSO PROVIDES SCHOLARSHIPS. APPLICATION FORMS ARE CREATED BASED ON THE QUALIFICATIONS FOR WHICH THE SCHOLARSHIP IS BASED. ADVERTISING IS DONE WHICH INCLUDES CRITERIA OF SCHOLARSHIP REQUIREMENTS AND DEADLINE. A COMMITTEE IS FORMED FOR EACH SCHOLARSHIP. RECIPIENTS FOR THE SCHOLARSHIP ARE BASED ON THEIR MERITS AND ACCOMPLISHMENTS. COMMITTEE MEMBERS ARE IMPARTIAL AND A DECISION FOR THE RECIPIENT IS MADE BASED ON THE GROUP'S DECISION. IN FYE 2011, 4 MEDICAL SCHOOL STUDENTS WERE CHOSEN FOR $5,000 SCHOLARSHIPS.	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 (9 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
MICHAEL SCHURRER
172947	0	62529	0	33299	0	12374	0	59757	0	340906	0	0	0
PAMELA J REZAC
0	457910	0	0	0	11769	0	12250	0	18885	0	500814	0	0
DOUGLAS EKEREN
145511	0	22980	0	4128	0	9643	0	34357	0	216619	0	0	0
MICHAEL PETERSON
399085	0	34868	0	60721	0	12564	0	55757	0	562995	0	0	0
BARRY A GRAHAM
200474	0	5994	0	23777	0	12564	0	41484	0	284293	0	0	0
STEVE GUTNIK
220596	0	0	0	343987	0	12564	0	20752	0	597899	0	0	0
SCOTT HILTUNEN
202397	0	22161	0	17257	0	12564	0	28257	0	282636	0	0	0
GREGORY ERICKSON
207334	0	11250	0	21884	0	12374	0	11923	0	264765	0	0	0
BARBARA LARSON
114887	0	10343	0	3846	0	8037	0	54896	0	192009	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 SACRED HEART RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT & CEO USING THE METHODS DESCRIBED IN PART I, LINE 3.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF CREIGHTON	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	476006152	IssuerEIN
Date Issued	2006-12-15	DateIssued
Issue Price	4110700	IssuePrice
Description Of Purpose	ADD ON AND IMPROVE EXISTING HEALTH CARE FACILITY	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Total Proceeds	4110700	TotalProceeds
Capital Expenditures	4110700	CapitalExpenditures
Year Of Subst Completion	2007	YearOfSubstCompletion
Current Refunding	1	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Counsel Routinely Engaged	1	BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	1	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Exception To Rebate	0	ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	JANET JANS	NamePerson

Field	Value	IRS element (for citing)
Relationship	SPOUSE OF BOARD MEMBER	Relationship
Amount Of Transaction	57965	AmountOfTransaction
Description Of Transaction	EMPLOYEE COMPENSATION	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	5	NumberOfContributions
Noncash Contribs Rptd F990	1055	NoncashContribsRptdF990
Method Of Determining Revenues	COST	MethodOfDeterminingRevenues

Clothing And Household Goods ClothingAndHouseholdGoods

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Noncash Contribs Rptd F990	104145	NoncashContribsRptdF990
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenues

Food Inventory FoodInventory

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	32	NumberOfContributions
Noncash Contribs Rptd F990	17800	NoncashContribsRptdF990
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenues

Drugs And Medical Supplies DrugsAndMedicalSupplies

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	5	NumberOfContributions
Noncash Contribs Rptd F990	1265	NoncashContribsRptdF990
Method Of Determining Revenues	FMV	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 (15 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
NEW PROGRAM SERVICES	FORM 990, PART III, LINE 2	WE EXPANDED OUR SERVICE AREA WITH THE PURCHASE OF CREIGHTON AREA HEALTH SERVICES, AND NOW PROVIDE HOSPITAL, LONG TERM CARE, CLINIC, AND HOME HEALTH SERVICES TO CREIGHTON, NEBRASKA AND THE SURROUNDING AREA. AVERA SACRED HEART HOSPITAL INSTALLED A NEW OPEN BORE MRI MACHINE THAT PROVIDES EXTREMELY HIGH QUALITY IMAGES AND WILL BE USED IN CONJUNCTION WITH THE UNIVERSITY OF SOUTH DAKOTA TO STUDY POST TRAUMATIC STRESS DISORDER IN RETURNING VETERANS.
FORM 990, PART VI, SECTION A, LINE 2		DOUG EKEREN, PAMELA J. REZAC, DAVE TIMPE, AND JAMIE A. SCHAEFER HAVE A BUSINESS RELATIONSHIP. SR. LUCILLE WELBIG AND PAMELA J. REZAC HAVE A 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		THE FORM 990 IS REVIEWED INITIALLY BY THE CEO AND CFO. THE RETURN IS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
	FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS,OFFICERS AND KEY EMPLOYEES. AT EACH BOARD MEETING, A REQUEST IS MADE FOR ALL BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST PERTAINING TO ANY ITEM LISTED ON THE AGENDA OR PERTAINING TO ANY POTENTIAL ITEM THAT COULD BE DISCUSSED DURING THE COURSE OF THE MEETING. THE DECLARATION OF CONFLICT OF INTEREST IS RECORDED IN THE MEETING MINUTES. THE BOARD MAKES A DETERMINATION OF WHETHER THERE IS A CONFLICT OF INTEREST AND IF SO, IMPLEMENTS THE PROCEDURE FOR EVALUATING THE ISSUE OR TRANSACTION INVOLVED. THE BOARD MEMBER OR OFFICER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND BOARD MEMBERS. THE INFORMATION IS MAINTAINED IN A DATABASE AND A REPORT IS PROVIDED TO THE BOARD.
		FORM 990, PART VI, SECTION B, LINE 15: 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 OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE APPROVES ALL SALARIES BASED ON COMPARABLE DATA AND DOCUMENTS THE BASIS FOR THEIR DECISION IN MEETING MINUTES. THE COMPENSATION OF OTHER OFFICERS, DIRECTORS, AND KEY EMPLOYEES IS REVIEWED ANNUALLY. THE ORGANIZATION UTILIZES THE RESOURCES OF AN OUTSIDE INDEPENDENT AGENCY FOR MARKET COMPARABILITY. THE COMPENSATION IS APPROVED WITHIN THE ANNUAL BUDGET APPROVED BY THE BOARD.
	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:	IN ADDITION TO TIME SPENT SERVING SACRED HEART HEALTH SERVICES, PAMELA J. REZAC, DAVID TIMPE AND JAMIE A. SCHAEFER AND DOUGLAS EKEREN ALSO OVERSEE OPERATIONS OF THE RELATED AFFILIATES AS BOARD MEMBERS AND OFFICERS. SISTER LYNN MARIE WELBIG SERVES A RELATED ORGANIZATION 2.5 HOURS PER MONTH. SR. LUCILLE WELBIG SERVES RELATED ORGANIZATIONS 6 HOURS PER MONTH.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 13,050,060. CAPITAL TRANSFERS, NET 1,151,956. NET ASSETS RELEASED FROM DONOR RESTRICTION -223,565. ELIMINATION OF SUBSIDIARIES CONSOLIDATED FOR FINANCIAL STATEMENTS -8,025,871. TOTAL TO FORM 990, PART XI, LINE 5: 5,952,580.
	FORM 990, PART XII, LINE 2C:	THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR SACRED HEART HEALTH SERVICES.
	PART III, LINE 4A:	(CONTINUED FROM PAGE 5 OF SCHEDULE O) COMMUNITY EDUCATION: AVERA SACRED HEART REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT SOUTHEASTERN SOUTH DAKOTA AND NORTHEASTERN NEBRASKA IN A VARIETY OF WAYS. FOR THE PAST FIVE YEARS, AVERA SACRED HEART HAS PARTNERED WITH HYVEE FOODS OF YANKTON AND THE YANKTON PUBLIC SCHOOL SYSTEM TO PROMOTE BETTER EATING HABITS FOR STUDENTS AND CENTERED ON THE '5-TO-9-A-DAY' EDUCATIONAL FORMAT THAT IS NOW TRANSITIONING TO THE "MY PLATE" CONCEPT. COMMUNITY FLU SHOT CLINICS ARE GENERALLY HELD THROUGHOUT THE REGION. THROUGH WELL COORDINATED EFFORTS STATEWIDE WITH OTHER HOSPITALS AND STATE ENTITIES, AVERA SACRED HEART WAS ABLE TO EFFECTIVELY DISTRIBUTE THE VACCINE DOSES IT RECEIVED IN A TIMELY AND EFFICIENT MANNER. WE ARE PROUD OF OUR CONTINUING 'TO BE WELL' HEALTH CARE EDUCATIONAL SERIES THAT PROVIDES EDUCATION TO THE COMMUNITY ON A VARIETY OF DISEASES AND CHRONIC CONDITIONS. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, STUDENTS, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS OF ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING THE AVERA PROFESSIONAL OFFICE PAVILION AND EDUCATION CENTER, HUNDREDS OF CLASSES INVOLVING THOUSANDS OF PEOPLE ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR. OTHER EXAMPLES OF COMMUNITY EDUCATION INCLUDE OUR STUDENT/YOUTH MENTORING PROGRAMS AND PARISH NURSING. PARTNERSHIPS WITH SCHOOLS, CHURCHES, BUSINESSES AND OTHER ORGANIZATIONS MAKE MANY OF THESE PROGRAMS POSSIBLE. ONE OF "MOST WIRED" AND "MOST WIRELESS" HOSPITALS: AVERA AND AVERA SACRED HEART HOSPITAL WERE NAMED "MOST WIRED" BY HOSPITALS & HEALTH NETWORKS MAGAZINE FOR THE 13TH YEAR IN A ROW. THE AWARD RECOGNIZED HOSPITALS THAT SUCCESSFULLY USE TECHNOLOGY TO ENHANCE PATIENT CARE AND QUALITY. AS AN INTEGRATED ORGANIZATION, AVERA AND AVERA SACRED HEART ARE LEADERS IN THE IMPLEMENTATION OF THE ELECTRONIC PATIENT RECORD (EMR). IN FY11, SEVERAL NEW CLINICS WERE ADDED TO THE ASHH ELECTRONIC MEDICAL RECORD SYSTEM AS THE NATION MOVES TOWARD MORE INTEGRATED MEDICINE. COMMITMENT TO QUALITY: AVERA SACRED HEART IS ACCREDITED BY THE JOINT COMMISSION AND JUST RECEIVED ANOTHER THREE-YEAR ACCREDITATION IN 2011. IN FY11, THE HOSPITAL WAS NAMED ONE OF A FEW HOSPITALS IN THE NATION TO ACHIEVE TOP DECILE RANKINGS IN THREE CLINICAL FOCUS AREAS IN THE CMS/PREMIER QUALITY PROJECT BASED ON ITS SECOND-YEAR SCORES IN HEART ATTACK HEART FAILURE AND PNEUMONIA.
	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).
	FORM 990, PART VI, LINE 16:	THERE IS NO WRITTEN POLICY OR PROCEDURE 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.

Schedule R IRS990ScheduleR

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	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
AVERA HEALTH
3900 WEST AVERA DRIVE SUITE 300	SIOUX FALLS	SD	57108	460422673	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 9	N/A	0
SACRED HEART RURAL HEALTH CLINICS INC
501 SUMMIT STREET	YANKTON	SD	57078	460423930	CLINIC SERVICES	SD	501(C)(3)	LINE 3		1	SACRED HEART HEALTH SERVICES
HEALTH MANAGEMENT SERVICES
501 SUMMIT	YANKTON	SD	57078	460399291	ADULT DAYCARE AND HOMEMAKING SERVICES	SD	501(C)(3)	LINE 9		1	SACRED HEART HEALTH SERVICES
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		1	SACRED HEART HEALTH SERVICES
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		0	AVERA HEALTH
AVERA ST ANTHONY'S HOSPITAL
300 N 2ND STREET	ONEILL	NE	68763	470463911	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA HOLY FAMILY
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	420680370	HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	421317452	FUNDRAISING	IA	501(C)(3)	LINE 9		0	AVERA HOLY FAMILY
AVERA MARSHALL
300 S BRUCE ST	MARSHALL	MN	56258	410919153	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA MARSHALL FOUNDATION
300 S BRUCE ST	MARSHALL	MN	56258	411784801	FUNDRAISING	MN	501(C)(3)	LINE 7		0	AVERA MARSHALL
ST BENEDICT HEALTH CENTER
401 WEST GLYNN DRIVE	PARKSTON	SD	57366	460226738	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH
ST BENEDICT HEALTH CENTER FOUNDATION
WEST GLYNN DRIVE PO BOX B	PARKSTON	SD	57366	460458725	SUPPORT HEALTH RELATED SERVICES	SD	501(C)(3)	LINE 11A, I		0	ST BENEDICT HEALTH CENTER
AVERA MCKENNAN
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	460224743	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA QUEEN OF PEACE HOSPITAL
525 N FOSTER STREET	MITCHELL	SD	57301	460224604	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA ST LUKE'S
305 SOUTH STATE STREET	ABERDEEN	SD	57401	460224598	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH

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	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA ST	ABERDEEN	SD	57401	460461429	SURGICAL ASSOCIATES	SD	N/A
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	460488198	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		AVERA MCKENNAN	RELATED	175266	1324753	0	$50,687	0	0.23000
MIDWEST REGIONAL IMAGING SERVICES LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	470874983	HEALTH CARE - MEDICAL IMAGING	SD	N/A
MERSCO MEDICAL EQUIPMENT OF PIERRE LLC
329 E DAKOTA	PIERRE	SD	57501	460444002	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF FLOYD VALLEY HOSPITAL LLC
714 LINCOLN ST NE	LEMARS	IA	51031	820582350	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC
PO BOX 5045	SIOUX FALLS	SD	57117	201686097	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC
38 19TH ST SW	SIOUX CENTER	IA	51250	753203100	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC
1104 EAST COLLEGE DRIVE	MARSHALL	MN	56258	205271924	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVENUE 102	SIOUX FALLS	SD	57117	800619999	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
Q&M PROPERTIES
525 NORTH FOSTER	MITCHELL	SD	57301	731652049	MEDICAL CLINIC BUILDING	SD	N/A
HEART HOSPITAL OF SOUTH DAKOTA LLC
10720 SIKES PLACE SUITE 300	CHARLOTTE	NC	28277	562143771	HEALTHCARE SERVICES	NC	N/A

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	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
VALLEY HEALTH SERVICES INC
501 SUMMIT STREET	YANKTON	SD	57078	460357149	MEDICAL EQUIPMENT	SD	N/A	C	128060	3552246	1.00000
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	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

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
SACRED HEART RURAL HEALTH CLINICS
Q	250000	RECORDED IN GENERAL LEDGER
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
K	70756	RECORDED IN GENERAL LEDGER
HEALTH MANAGEMENT SERVICES
A	19457	RECORDED IN GENERAL LEDGER
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
A	26012	RECORDED IN GENERAL LEDGER
SACRED HEART RURAL HEALTH CLINICS
N	91474	RECORDED IN GENERAL LEDGER
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
N	352894	RECORDED IN GENERAL LEDGER
HEALTH MANAGEMENT SERVICES
N	62369	RECORDED IN GENERAL LEDGER
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
O	190114	RECORDED IN GENERAL LEDGER
SACRED HEART RURAL HEALTH CLINICS
N	104280	RECORDED IN GENERAL LEDGER