2026-05-15T09:26:45-05:00 2025-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-07-01 460225483 Sacred Heart Health Services SACR 6056688000 501 Summit St Yankton SD 57078 Julie Lautt CFO Avera Health 6056688000 2026-05-11 1 1 Kim Hunwardsen CPA P00484560 6122536500 2026-05-11 2024 2025-03-06 01:10:19Z Avera Sacred Heart Hospital Victoria Hanson 501 Summit St Yankton SD 57078 182463294 0 0928 X avera.org/locations/sacred-heart/ X 1911 SD Promotion of health 13 11 1320 144 0 0 1074371 1672607 149904263 162974278 5226375 16493463 601766 1067979 156806775 182208327 55165 55 0 0 81169268 85897729 0 0 22854 68394143 74315056 149618576 160212840 7188199 21995487 429209949 475799064 44315601 47272680 384894348 428526384 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. 0 0 145339600 55 163329518 Avera Sacred Heart's mission is to provide healthcare services to Yankton, South Dakota residents and residents of the surrounding area. Avera Sacred Heart is a 501(c)(3) organization affiliated with Avera Health. Avera Sacred Heart consists of a 69-bed hospital and a 194-bed nursing home, congregate housing facility and a hospice house in Yankton, SD, a 17-bed critical access hospital and a 47-bed nursing home in Creighton, NE, and 15 physician clinics. The physician clinics include primary care, ob/gyn, ENT/audiology, gastroenterology, pediatrics, orthopedics, general surgery, internal medicine, radiology, oncology, podiatry, therapy, dialysis, behavioral health, and palliative care. Following is a breakdown of these statistics by facility:Avera Sacred Heart Hospital 2,926 Acute inpatient discharges 510 Newborn patient discharges 91 Swing bed patient discharges 95,890 Outpatient visits 462 Swing-bed patient days 1,209 Newborn patient days 38,335 Clinic visitsAvera Sacred Heart Majestic Bluffs 301 Long term care patient discharges 66,777 Long-term care resident daysAvera Creighton Hospital (CAH) 108 Acute inpatient discharges 54 Swing bed patient discharges 8,760 Outpatient visits 605 Swing-bed patient days 19,976 Clinic visitsAvera Creighton Care Centre 42 Long term care patient discharges 13,974 Long-term care resident daysAvera Sacred Heart maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $4,388,237.Avera Sacred Heart also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera Sacred Heart upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera Sacred Heart engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. 145339600 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 173 0 1 1320 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 1 0 X X Jamie A Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1274363 20218 Steve Gutnik MD FACP Gastroenterology & Internal Medicine 40.00 0.00 X 932436 0 30676 Timothy Mikesell MD Radiology 40.00 0.00 X 812450 0 34611 Ryan Sieg MD Orthopedics,Surgery & Sports Med 40.00 0.00 X 769488 0 65634 Michael Peterson MD Radiation Oncology & Oncology 40.00 0.00 X 645974 0 44719 Douglas Ekeren President/CEO (Until May) 42.00 1.00 X X 0 639691 50728 Matthew Winkelbauer MD Family Medicine/OB 40.00 0.00 X 638406 0 52408 Victoria Hanson President/CEO (Beg. May) 40.00 0.00 X X 0 0 0 Kathy Greeneway Chair 2.00 0.00 X X 0 0 0 Amy Leon Vice Chair 2.00 0.00 X X 0 0 0 Carolyn Becker Board Member 2.00 0.00 X 0 0 0 Bernie Hunhoff Board Member 2.00 0.00 X 0 0 0 Jack Hurley Board Member 2.00 0.00 X 0 0 0 Sr Debra Kolecka Board Member 2.00 9.00 X 0 0 0 Beth Mikkelsen MD Board Member 2.00 0.00 X 0 0 0 Steve Schindler Board Member 2.00 0.00 X 0 0 0 Steve Schmeichel Board Member 2.00 0.00 X 0 0 0 Brian Steward Board Member 2.00 0.00 X 0 0 0 Richard Strom MD Board Member 2.00 0.00 X 0 0 0 Sr Lucille Welbig Board Member 2.00 10.00 X 0 0 0 3798754 1914054 298994 117 0 1 0 Avera Health 3900 W Avera Dr Ste 301 Sioux Falls SD 57108 Shared Services 13237985 Yankton Medical Clinic PC 1104 W 8th St Yankton SD 57078 Physician Services 2478937 Yankton Anesthesiology PC 1000 W 4th St Ste 13 Yankton SD 57078 Purchased Services 1461014 AMN Healthcare Inc 12400 High Bluff Dr San Diego CA 92130 Staffing Services 1226892 Willcockson Eye Association PO Box 819 Yankton SD 57078 Medical Services 1209568 34 1197751 469856 5000 1672607 Net Patient Service Revenue 621110 157755410 157755410 Pharmacy Revenue 456110 2323098 2323098 Patient and Clinic Revenue 621110 424240 424240 2471530 2471530 162974278 6645 6645 959073 246334 712739 712739 712739 16469951 25500 0 8633 16469951 16867 16486818 16486818 A/R Interest Income 900099 355240 355240 355240 182208327 163329518 0 17206202 X 55 55 168585 168585 69248375 67974604 1273771 2671119 2597315 73804 9247184 9052773 194411 4562466 4458469 103997 50028 19 50009 4849 4849 32146333 22532205 9614090 38 15956 14241 1431 284 1317586 1033114 282764 1708 763427 758964 4463 3421467 2950485 470982 287384 263880 23504 235583 212415 23168 1356865 767524 589341 7232060 5881520 1348744 1796 299718 33828 265890 Medical Supplies 25055080 25002556 51797 727 Equipment Lease/Rental 157909 151558 6351 1970811 1485490 467020 18301 160212840 145339600 14850386 22854 1122446 -69031 18906857 19455194 2700818 2862852 852498 904861 184538321 132729924 53364736 51808397 342746334 384071618 2125940 2266942 7257282 7187103 133038 7311128 429209949 475799064 11080739 11132675 -66219 -73848 19348769 19348769 58692 56982 13469418 12677906 424202 4130196 44315601 47272680 X 370352335 410711509 14542013 17814875 384894348 428526384 429209949 475799064 X 21995487 18706114 2930435 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4849 4849 0 Part II-B, Line 1: Sacred Heart Health Services paid dues to organizations which have a portion of the dues attributed to lobbying activities. 0 1 X 824032 7202 8 831226 816175 7857 824032 807800 8389 14 816175 799040 9465 705 807800 778088 21096 144 799040 0.00000 0.82215 0.17785 0 1 1 5012940 5012940 120096256 86195654 33900602 43119 7397 35722 51345741 40291992 11053749 8040265 6234881 1805384 51808397 Avera Pooled Investments 365610709 F Interest in Avera Health Foundation 18460909 F 384071618 Derivative Liability 107749 Due to Third Party Payors 352429 Intercompany Liabilities 3443200 Security Deposits 203150 Right of Use Capital Lease 23668 4130196 X Part IV, Line 2b: Resident trust funds are held on behalf of the residents. Part V, Line 4: The Organization's endowments consist of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. Part X, Line 2: Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 1261121 1261121 0.00790 9329160 4751286 4577874 0.02860 48755 35312 13443 0.00010 10639036 4786598 5852438 0.03660 561950 561950 0.00350 1355 1355 0.00000 2031076 847201 1183875 0.00740 226260 226260 0.00140 2820641 847201 1973440 0.01230 13459677 5633799 7825878 0.04890 40000 40000 0.00030 40000 40000 0.00030 1 2234196 52023832 58625940 -6602108 X 1 1 2 1 Avera Sacred Heart Hospital 501 Summit Street Yankton SD 57078 See Part V Section C 10576 X X X 7 provider based clinics 2 Avera Creighton Hospital 1503 Main Street Creighton NE 68729 See Part V Section C 490001 X X X X 1 provider based clinic and 5 RHC's Avera Sacred Heart Hospital 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X See part V Section C X See Part V Section C X 1 24 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V Section C X See Part V Section C X See Part V Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Avera Creighton Hospital 2 0 0 1 X X X X X X X X X 24 1 0 1 1 X See Part V Section C X See Part V Section C X 1 24 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V Section C X See Part V Section C X See Part V Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Avera Sacred Heart Hospital Part V, Section B, Line 5: Avera Sacred Heart utilized aspects of the Community Health Needs Assessment and Implementation Planning toolkit developed by the South Dakota Department of Health and focus groups conducted by Maximizing Excellence, LLC to conduct the FY2025 Community Health Needs Assessment. The process involved determining the participant's opinions on the community's strengths, weaknesses, resources, and improvements. Careful consideration was taken to ensure that input gathered was representative of the community at large, including the medically underserved, low-income or minority populations. Avera Creighton Hospital Part V, Section B, Line 5: Avera Creighton Hospital, in collaboration with the North Central District Health Department (NCDHD), used key informant interviews with area health care providers and leadership, focus groups, and a general community survey. The community input was used to determine the community's strengths and assets, threats and weaknesses, opportunities for improving, and resources. Those providing community input represented the medically underserved, low-income and minority populations as they serve with these populations through their activities. Avera Creighton Hospital Part V, Section B, Line 6b: North Central District Health Department Avera Sacred Heart Hospital Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Mental Health - Chronic Disease ManagementPRIORITY 1: Mental HealthGoal: Increase community resources relating to mental wellness.PRIORITY 2: Chronic Disease ManagementGoal: Increase community resources relating to chronic disease management.The following health needs were not addressed in this Implementation Plan; however, Avera Sacred Heart Hospital will continue to assess and monitor these needs through planning efforts to serve the health and well-being of the service area communities. - Affordable housing - Transportation - Affordable Child Care - Food Security - Transparency and CommunicationAvera Sacred Heart continued to address the community health needs identified in the community health needs assessment completed in FY2022. The following community health priority areas were identified and prioritized in the community health needs assessment process: Behavioral health and substance abuse/addiction and workforce and health care capacity.Avera Sacred Heart maintained its implementation plan to address the needs identified and prioritized in the FY2022 Community health needs assessment.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE/ADDICTIONIncrease community resources relating to behavioral health with special focus on substance abuse and addiction issues.-Avera Sacred Heart continues to support Lewis & Clark's C.O.R.E. Center in the Benedictine Center on the Avera Sacred Heart campus.-Avera Sacred Heart provided letters of support and advocacy for Lewis & Clark Behavioral Health Services new facility. -Avera Sacred Heart continued pursuing a state grant opportunity with Lewis & Clark to expand chemical dependency services and programing. -Avera Sacred Heart continues to actively recruit psychologists and/or psychiatrists to practice in Yankton. -Avera Sacred Heart continues to utilize Avera's "Ask the Question: Are you thinking about suicide" campaign. The campaign has been integrated into the care delivery model at Avera Sacred Heart. -Avera Sacred Heart continues to utilize SBIRT (Screening, Brief Intervention, and Referral to Treatment), an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.-Avera Sacred Heart continues to use the Edinburgh Scale for depression and suicide screening for OB patients. WORKFORCE AND HEALTH CARE CAPACITYIncrease workforce and health care capacity to adequately prepare Avera Sacred Heart to meet the future needs of the community.-Further develop and implement an Avera Sacred Heart version of Avera Academy that fits the Yankton community. Avera Sacred Heart created the Avera Academy Camp in conjunction with the Yankton School District, Mount Marty University, and Yankton Thrive for high school students. The Avera Academy is a three & a half day program. In FY25, the program was expanded to an addition five school districts in Avera Sacred Heart's surrounding service area.-Further develop and implement the Avera Scholars program with Mount Marty University. -Continued to develop and implement an Avera Nurse Residency Program at Avera Sacred Heart for new college graduates. In FY25, there were 17 participants. -Continued to develop and implement a Nurse Recruitment Team with the Avera Sacred Heart Endowed Chair of Nursing recipient at Mount Marty University. The Avera Director of Talent Management and the Endowed Chair of Nursing at Mount Marty University have continued to meet regularly. In FY25, Avera and Mount Marty University announced the Avera Nursing Advantage program for junior and senior nursing students. -Continue to utilize Build Dakota Scholarships to build a workforce for Avera Sacred Heart in difficult to recruit positions. Avera Sacred Heart will continue to recruit students for this opportunity. The Build Dakota Scholarship offers students a full-ride scholarship at a South Dakota Technical College in certain in-demand industries.-Continue to promote the Avera Student Loan Program benefit and evaluate critical needs for eligibility with the program. Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Avera Creighton Hospital Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Mental Health - Chronic ConditionsPRIORITY 1: Mental Health - Improve access to behavioral health providers - Behavioral Health education for health care providers and nursing staff - Behavioral Health education in collaboration with the area school system on suicide prevention - Behavioral Health education for the community - Utilize media outlets to increase awareness of Mental Health and SuicidePIORITY 2: Chronic Conditions - Explore options for increasing the number and location of blood pressure screenings in the community - Explore options for increasing physical activity opportunities to the Community - Explore options for providing certified diabetes education in the facility - Increase the amount of healthy food options available to the employees - Increase amount of CPR certified instructors in the CommunityThe following health needs were not addressed in this Implementation Plan; however, Avera Creighton Hospital will continue to assess and monitor these needs through planning efforts to serve the health and well-being of the service area communities. - No after-hours care options outside of Emergency Department for urgent, but non-emergent conditions - ACH has limited staffing availability to expand clinic hours in the evenings, which leaves the Emergency Department as the only option for after-hours care in the area. Avera Creighton continued to address the community health needs identified in the community health needs assessment completed in FY2022. Avera Creighton maintained its implementation plan for each of the priorities of Behavioral Health and Heart Health. The following actions were taken during FY2025 to address the needs identified in the FY2022 community health needs assessment:BEHAVIORAL HEALTH-Avera Creighton staff participated in area health fairs offering blood pressure screenings and behavioral health and suicide information.-Avera Creighton continued to utilize media outlets to increase awareness of Mental Health and Suicide through Avera's "Ask the Question" campaign.-Avera Creighton continued screening for Social Determinants of Health disparities upon admission. The screening includes questions on safety, living situation, utilities, and access to food and transportation. Any positive screens flow to the Case Management and Social Service Referral list for follow up. -Mental Health services continue to be provided through the bi-weekly outpatient clinic with a Mental Health Nurse Practitioner for medication management and follow up and outpatient counseling services through the downtown Creighton location.-Avera Creighton continued to utilize the CredibleMind online platform through the North Central District Health Department. This is a free resource that allows users to take mental health assessments, learn new coping skills, and search the library of thousands of mental wellbeing resources. HEART HEALTH - Avera Creighton continued to offer free blood pressure screenings at local events. - Avera Creighton continued to offer patient education focused on definition and treatment of hypertension at the local farm events. - Avera Creighton offers wellness screenings for employees of North Central District Health Department. - Avera Creighton continued to offer an outpatient cardiac rehabilitation program. - Avera Creighton added an outpatient cardiology clinic day to the monthly schedule. - The Planet Heart screening program was investigated to determine if the service could be provided at the Avera Creighton facility. Due to the cost of the software needed for the CT scanner, it was determined that offering the program at Avera Creighton was not feasible at this time, but the program is available within the Avera Sacred Heart Region. Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Avera Sacred Heart Hospital Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. Avera Creighton Hospital Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. Avera Sacred Heart Hospital Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. Avera Creighton Hospital Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. Avera Sacred Heart Hospital Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. Avera Creighton Hospital Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. Avera Sacred Heart Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. Avera Creighton Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. Part V, Section A organization's website The website for Avera Sacred Heart Hospital is:avera.org/locations/sacred-heart/The website for Avera Creighton Hospital is:avera.org/locations/profile/avera-creighton-hospital Part V, Section B, Line 7a, 7b, and 10a: www.avera.org/about/community-health-needs-assessments/www.avera.org/about/community-health-needs-assessments/ Part V, Section B, Line 16a, 16b, and 16c: avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ 7 1 - Avera Sister James Care Center 2111 W 11th Street Yankton SD 57078 Skilled nursing facility 2 - Avera Sacred Heart Majestic Bluffs 2111 W 11th Street Yankton SD 57078 Assisted living 3 - Avera Sacred Heart Hospital-Swing Bed 501 Summit Street Yankton SD 57078 Swing Bed 4 - Avera Creighton Care Centre 1603 Main Street Creighton NE 687292999 Long Term Care 5 - Avera Sacred Heart Hospital-Dialysis 501 Summit Street Yankton SD 57078 Dialysis Unit 6 - AMG Gastroenterology 1104 West 8th Street Yankton SD 57078 Gastroenterology clinic 7 - AMG Willcockson Eye Associates 415 W Third Yankton SD 57078 Optical/Eye Clinic Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 6a: The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/. Part I, Line 7: A combination of costing methodology was used to calculate the amounts reported in the table. A cost accounting system was used to calculate Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for our tertiary medical center. A cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate charity care at cost for all entities and Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for any operations outside of the tertiary medical center. For all other amounts, costs and revenues as reflected by the general ledger system were used. Part II, Community Building Activities: The community building activities include monetary assistance to organizations that focus their efforts on providing furniture for low income families and neighborhood improvement projects in high needs areas. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 18 and 19. Part III, Line 8: Sacred Heart Health Services provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. 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 Centers for Medicare and Medicaid Services. 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 current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. 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 responds with preventative/educational information or activities for the community. Part VI, Line 3: Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs. Part VI, Line 4: Avera Sacred Heart is a 69-bed hospital in Yankton, South Dakota. Avera Sacred Heart primarily serves the city and county of Yankton and the counties of Bon Homme, Charles Mix, Hutchinson and Clay in South Dakota and counties of Knox and Cedar in Nebraska. The majority of discharges are from Yankton County. According to the U.S. Census Bureau Quick Facts 2025 data, the estimated population of Yankton County as of July 1, 2024, is 23,509 and is predominately white at 91.9%. It is estimated that 23.2% of the population is 65 years and over. The median household income is $72,821 with a 10.9% poverty rate. Uninsured individuals under age 65 is estimated at 9.2%. Part VI, Line 5: 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 and Swing-bed 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 hours a day emergency service. 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 Radiology Technologist program that graduates approximately 6 students per year. Sacred Heart Hospital also provides clinical education for Mount Marty University students. Part VI, Line 6: Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera 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. 0 0 0 0 0 0 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0 1226098 0 41964 0 6301 0 17250 0 2968 0 1294581 0 0 Steve Gutnik MD FACP Gastroenterology & Internal Medicine 874264 0 18361 0 39811 0 17250 0 13426 0 963112 0 0 0 Timothy Mikesell MD Radiology 742066 0 25623 0 44761 0 17182 0 17429 0 847061 0 0 0 Ryan Sieg MD Orthopedics,Surgery & Sports Med 681534 0 15000 0 72954 0 17250 0 48384 0 835122 0 0 0 Michael Peterson MD Radiation Oncology & Oncology 619571 0 15000 0 11403 0 17250 0 27469 0 690693 0 0 0 Douglas Ekeren President/CEO (Until May) 0 607102 0 21842 0 10747 0 17250 0 33478 0 690419 0 0 Matthew Winkelbauer MD Family Medicine/OB 540996 0 94953 0 2457 0 17250 0 35158 0 690814 0 0 0 Schedule J, Part I Line 3: The President/CEO is compensated by 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. Lawrence Leon MD Family member of board member 168585 Employee compensation and benefits 0 Form 990, Part VI, Section A, line 2 Julie Lautt, Sr. Debra Kolecka, Sr. Lucille Welbig, Victoria Hanson and Douglas Ekeren 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, as the sole member, 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 A, line 8b Avera does not have any committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members. 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 15b The CEO and CFO of Avera Health was compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of the Caring for Life Catholic Health Ministries Members of Avera Health, meet 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. Depending on the individual's role with the organization, some officers and key employees are compensated by Sacred Heart Health Services. 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 IX, line 11g Purchased Services: Program service expenses 8,997,785. Management and general expenses 699,230. Fundraising expenses 0. Total expenses 9,697,015. Medical Professional Fees: Program service expenses 3,892,816. Management and general expenses 708,490. Fundraising expenses 0. Total expenses 4,601,306. Repairs & Maintenance: Program service expenses 3,356,778. Management and general expenses 115,041. Fundraising expenses 38. Total expenses 3,471,857. Centralized Services: Program service expenses 6,284,826. Management and general expenses 8,091,329. Fundraising expenses 0. Total expenses 14,376,155. Form 990, Part XI, line 9: Change in Interest in Avera Foundation -894,070. Change in Assets with Donor Restrictions 3,272,861. Other changes in net assets 14,310. Net asset transfer - Valley Health Services 537,334. Form 990, Part XII, Line 2c: The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the audited financial statements for Avera Health, which includes Sacred Heart Health Services. Form 990, Part X, Line 20: The issue price includes the filing organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg, Avera at Home, and Sacred Heart Health Services. 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). Avera Health 3900 West Avera Drive Suite 300 Sioux Falls SD 57108 460422673 Healthcare services SD 501(c)(3) Line 10 N/A 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera at Home 5300 S Broadband Lane Sioux Falls SD 57108 460399291 Home Services SD 501(c)(3) Line 10 Avera Health 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing and health plans admin SD 501(c)(4) Avera Health 0 Avera Marshall 300 S Bruce St Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 0 Avera Granite Falls 345 10th Ave Granite Falls MN 56241 843156881 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Queen of Peace Hospital 525 N Foster Street Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare services NE 501(c)(3) Line 3 Avera Health 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 0 Holy Family Hospital Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 Lewis and Clark Health Education and Service Agency 1000 W 4th Street Suite 9 Yankton SD 57078 460337013 Healthcare services SD 501(c)(3) Line 10 Avera Health 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Home Medical Equipment of Floyd Valley Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 820582350 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Lakes Regional Healthcare LLC 5300 S Broadband Lane Sioux Falls SD 57108 862949748 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Sioux Center LLC 5300 S Broadband Lane Sioux Falls SD 57108 753203100 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Spencer Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 800619999 Medical services - home medical equipment SD N/A 0 0 Brookings Health System - Avera HME LLC 100 22nd Ave Suite 101 Brookings SD 57006 453204123 Medical services - home medical equipment SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 20 Burton Hills Blvd Ste 100 Nashville TN 37215 611843657 Accountable care organization MO N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 20 Burton Hills Blvd Ste 100 Nashville TN 37215 821447782 Accountable care organization MO N/A 0 0 Heart Hospital of South Dakota LLC 4500 W 69th Street Sioux Falls SD 57108 562143771 Healthcare services NC N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Pennsylvania St Aberdeen SD 57401 460461429 Surgical associates SD N/A 0 0 Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection agency SD N/A C 0 Alucent Australia Pty Ltd Level 10 30 Collings Street Melbourne VIC 3000 AS Biotech Research AS N/A 0 Alucent Biomedical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 Avera Property Insurance Inc 1000 West 4th Street Suite 1 Yankton SD 57078 460463155 Insurance SD N/A C 0 DakotaCare Administrative Services Inc 5300 South Broadband Lane Sioux Falls SD 57108 460424322 Insurance SD N/A C 0 Kore Cares In Home Services LLC 5300 South Broadband Lane Sioux Falls SD 57108 882778902 In-home care services SD N/A S 0 South Dakota State Medical Holding Company Inc 5300 South Broadband Lane Sioux Falls SD 57108 460401087 Insurance SD N/A C 0 Valley Health Services Inc 501 Summit Street Yankton SD 57078 460357149 Rental real estate SD Sacred Heart Health Services C 130251 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 Valley Health Services S 537334 book value Form 990, Schedule R, Part II: Tax Exempt Organizations Holy Family Hospital Foundation dissolved November 2024. Form 990, Schedule R, Part IV: Related Corporations or Trusts Valley Health Services dissolved June 2025. Alucent Biomedical, Inc. dissolved May 2025. Alucent Australia Pty Ltd dissolved May 2025.