2012-05-15T13:23:43-05:00 2011-06-30 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2010-07-01 460225483 SACRED HEART HEALTH SERVICES SACR 6056688000 501 SUMMIT STREET YANKTON SD 57078 PAMELA J REZAC 6056688000 2012-05-14 1 KIM HUNWARDSEN CPA 6122536500 2012-05-14 2010 2016-02-24 21:20:13Z AVERA SACRED HEART HOSPITAL PAMELA J REZAC 501 SUMMIT STREET YANKTON SD 57078 104146553 0 0928 X WWW.AVERASACREDHEART.COM X 1911 SD PROMOTION OF HEALTH 13 10 1022 338 50687 48952 537621 580917 86234554 98322426 1942062 4477513 -371345 -195948 88342892 103184908 70550 877341 0 0 43438643 49947165 0 0 100428 37746072 41312851 81255265 92137357 7087627 11047551 207545147 230597519 27518006 33570247 180027141 197027272 X AVERA IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES. 1 0 76443147 877341 98271739 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) 76443147 1 1 0 1 0 0 0 1 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 119 0 1 1022 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X JAMIE A SCHAEFER 6056688776 501 SUMMIT YANKTON SD 57078 X AMY FREEBURG 2.00 X X 0 0 0 ROB STEPHENSON 2.00 X X 0 0 0 MICHAEL PIETILA 2.00 X 0 0 0 SR MARY KAY PANOWICZ 2.00 X 0 0 0 SR CORRINE LEMMER 2.00 X 0 0 0 BRAD DYKES 2.00 X 0 0 0 JOHN NAGENGAST 2.00 X 0 0 0 MICHAEL SCHURRER 40.00 X 268775 0 72131 MARTY JANS 2.00 X 0 0 0 SR LUCILLE WELBIG 2.00 X 0 0 0 SR LYNN MARIE WELBIG 2.00 X 0 0 0 MARY PAT BIERLE 2.00 X 0 0 0 PAMELA J REZAC 60.00 X X 0 469679 29676 DAVID A TIMPE 52.00 X 89856 0 20480 JAMIE A SCHAEFER 52.00 X 64905 0 11434 DOUGLAS EKEREN 52.00 X 172619 0 44000 MICHAEL PETERSON 40.00 X 494674 0 68321 BARRY A GRAHAM 40.00 X 230245 0 54048 STEVE GUTNIK 40.00 X 564583 0 33316 SCOTT HILTUNEN 40.00 X 241815 0 40821 GREGORY ERICKSON 40.00 X 240468 0 24297 BARBARA LARSON 52.00 X 129076 0 62933 2497016 469679 461457 34 1 1 0 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 8 30561 30000 520356 124265 580917 NET PATIENT SERVICE RE 622110 95589485 95589485 NONMEDICAL OUTREACH 900099 1684685 1684685 OTHER REVENUE 900099 765654 765654 INCOME FROM AFFILIATES 900099 282602 231915 50687 98322426 1540041 1540041 335355 714038 -378683 -378683 -378683 3173723 236251 3173723 -236251 2937472 2937472 25564 30561 11356 14208 14208 INTEREST INCOME 900099 168527 168527 168527 103184908 98271739 50687 4281565 877341 877341 729342 347634 381708 187712 187712 39967701 33704463 6182293 80945 967079 824418 140653 2008 5681778 4771054 899251 11473 2413553 2013145 395581 4827 8096 8096 55558 55558 10320116 5889963 4430153 641643 40263 601380 6337241 5343076 994165 26128 1340 24788 2187484 1859268 328216 430319 319156 111163 514573 186618 327955 783036 783036 7225439 7225439 761117 760782 335 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 535210 165158 368877 1175 92137357 76443147 15593782 100428 297909 472988 7643 11131387 17893469 818832 1375571 227877 562347 133050122 77780959 49232842 55269163 12618837 9234176 131742487 143519679 546969 797178 632157 640839 295850 824466 207545147 230597519 8429251 10576171 484638 909526 15665427 18707968 15732 2938690 3360850 27518006 33570247 X 168717932 184247593 10852413 12321763 456796 457916 180027141 197027272 207545147 230597519 X 11047551 5952580 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 31717 0 0 0 31717 0 0 1 716457 1120 87570 4083 801064 676350 540 41680 2113 716457 721018 11570 -18197 38041 676350 0.57160 0.42840 0 0 3455133 3455133 84330223 47529719 36800504 38775438 27113203 11662235 6489328 3138037 3351291 55269163 ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS 142467130 F INVESTMENT IN AFFILIATED ORGANIZATION 1052549 C 143519679 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2950000 MARKET VALUE OF INTEREST RATE SWAP 410850 3360850 PART IV, LINE 2B: RESIDENT TRUST FUNDS ARE HELD ON BEHALF OF THE RESIDENTS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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 UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. SIMPLY D'VINE 56125 38561 17564 477 7241 2538 1100 56125 38561 17564 477 7241 2538 1100 11356 6208 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 1030 961428 961428 0.01070 16111704 15206522 905182 0.01000 1030 17073132 15206522 1866610 0.02070 1490 166015 35364 130651 0.00140 620 1257665 266158 991507 0.01100 10419 4832067 4170387 661680 0.00730 40 42858 42858 0.00050 12569 6298605 4471909 1826696 0.02020 13599 23371737 19678431 3693306 0.04090 66645 66645 0.00070 89267 89267 0.00100 155912 155912 0.00170 1 854597 0 24665414 26954746 -2289332 X 1 1 2 1 AVERA SACRED HEART HOSPITAL

501 SUMMIT STREET YANKTON SD 57078

X X X 2 AVERA CREIGHTON HOSPITAL

1503 MAIN STREET CREIGHTON NE 68729

X X X X NOT REQUIRED 1 8 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 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. 1 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 4 SCHOLARSHIPS 4 20000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: 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. 0 0 0 0 0 0 0 0 0 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 SUPPLEMENTAL INFORMATION PART III 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. CITY OF CREIGHTON 476006152 2006-12-15 4110700 ADD ON AND IMPROVE EXISTING HEALTH CARE FACILITY 0 0 0 4110700 4110700 2007 1 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 JANET JANS SPOUSE OF BOARD MEMBER 57965 EMPLOYEE COMPENSATION 0 X 5 1055 COST X 104145 FMV X 32 17800 FMV X 5 1265 FMV 0 0 0 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. 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