STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

AVERA QUEEN OF PEACE: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
AVERA QUEEN OF PEACE (EIN 46-0224604)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-14
IRS object ID
202401359349309835
Schema version
2022v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-14T15:13:16-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460224604EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera Queen of PeaceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone6059952251PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1525 North Foster StreetAddressLine1Txt
CityMitchellCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJulie LauttPersonNm
Person TitleCFO Avera HealthPersonTitleTxt
Phone6059952251PhoneNum
Signature2024-05-08SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJuliePersonFirstNm
Person LastLauttPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2024-04-30PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Avera Queen of Peace Health ServiceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDouglas EkerenPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1525 North Foster StreetAddressLine1Txt
CityMitchellCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57301ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$134,798,010GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressSee Schedule OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1905FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionPromotion of healthActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee835TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$69,673TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,002,542PYContributionsGrantsAmt
CY Contributions Grants$389,291CYContributionsGrantsAmt
PY Program Service Revenue$127,612,680PYProgramServiceRevenueAmt
CY Program Service Revenue$130,773,538CYProgramServiceRevenueAmt
PY Investment Income$1,461,910PYInvestmentIncomeAmt
CY Investment Income$682,898CYInvestmentIncomeAmt
PY Other Revenue$1,117,133PYOtherRevenueAmt
CY Other Revenue$1,665,129CYOtherRevenueAmt
PY Total Revenue$134,194,265PYTotalRevenueAmt
CY Total Revenue$133,510,856CYTotalRevenueAmt
PY Grants And Similar Paid$32,479PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$44,405CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$67,453,045PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$69,325,678CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$58,704CYTotalFundraisingExpenseAmt
PY Other Expenses$59,879,470PYOtherExpensesAmt
CY Other Expenses$59,669,824CYOtherExpensesAmt
PY Total Expenses$127,364,994PYTotalExpensesAmt
CY Total Expenses$129,039,907CYTotalExpensesAmt
PY Revenues Less Expenses$6,829,271PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,470,949CYRevenuesLessExpensesAmt
Total Assets BOY$163,885,965TotalAssetsBOYAmt
Total Assets EOY$169,784,455TotalAssetsEOYAmt
Total Liabilities BOY$45,038,500TotalLiabilitiesBOYAmt
Total Liabilities EOY$41,104,298TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$118,847,465NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$128,680,157NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$118,323,044ExpenseAmt
Grant$44,405GrantAmt
Revenue$131,195,040RevenueAmt
DescAvera Queen of Peace's mission is to provide healthcare services to Mitchell, South Dakota residents and residents of the surrounding area. Avera Queen of Peace is a 501(c)(3) organization affiliated with Avera Health. Avera Queen of Peace consists of a 25-bed critical access hospital and an 84-bed nursing home in Mitchell, SD, a 16-bed critical access hospital in Wessington Springs, SD, a 6-bed critical access hospital in De Smet, SD and 8 physician clinics. The program services offered include orthopedics, general surgery, internal medicine, radiation, laboratory, radiology, sleep lab, wound care, emergency, EKG, EEG, IP surgery, OP surgery, oncology, dermatology, physical therapy, occupational therapy, speech therapy, pharmacy, ophthalmology, and optometry. They provide acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera Queen of Peace Hospital 1,682 Acute patient discharges 400 Newborn patient discharges 58 Swing Bed patient discharges91,776 Outpatient visits 483 Swing-bed patient days 824 Newborn patient days46,864 Clinic visitsAvera Brady Health and Rehabilitation 115 Long Term Care patient discharges25,052 Long-term care resident daysAvera Weskota Memorial Medical Center (CAH) 75 Acute patient discharges 28 Swing Bed discharges 4,856 Outpatient visits 341 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH) 79 Acute patient discharges 14 Swing Bed patient discharges 9,909 Outpatient visits 101 Swing-bed patient days 4,334 Clinic visitsAvera Queen of Peace 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 $4,323,742.Avera Queen of Peace 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 Queen of Peace 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 Queen of Peace 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.Desc
Total Program Service Expenses$118,323,044TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document110IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee835EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jamie SchaeferBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6053223992PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13900 W Avera Dr Ste 300AddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57108ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Douglas Ekeren
Regional President & CEO5.0044.00Yes (X)Yes (X)$0$704,190$46,432
Jay Tolsma
Chair2.000.00Yes (X)Yes (X)$0$0$0
Ryan Thompson
Vice Chair2.000.00Yes (X)Yes (X)$0$0$0
Darlene Bergeleen
Board Member2.000.00Yes (X)$0$0$0
Sister Kathleen Bierne
Board Member2.001.00Yes (X)$0$0$0
Jason Bradley
Board Member2.000.00Yes (X)$0$0$0
Julie Brookbank
Board Member2.000.00Yes (X)$0$0$0
Jessica Claussen MD
Board Member/Opthalmology42.000.00Yes (X)$599,987$0$54,150
Sister Erin Colgan
Board Member2.000.00Yes (X)$0$0$0
Stephanie Ellwein
Board Member2.000.00Yes (X)$0$0$0
Ryan Huber
Board Member2.000.00Yes (X)$0$0$0
Mark Hunhoff
Board Member2.000.00Yes (X)$0$0$0
Jean Koehler
Board Member2.000.00Yes (X)$0$0$0
Tracey Larson
Board Member2.000.00Yes (X)$0$0$0
Hilary Rockwell MD
Board Member/Emergency Medicine42.000.00Yes (X)$442,654$0$66,884
Jennifer Tegethoff MD
Board Member/Pediatrics42.000.00Yes (X)$437,453$0$49,410
Brad Zomer
Board Member2.000.00Yes (X)$0$0$0
Julie Lautt
CFO Avera Health;Secretary/Treasurer0.1046.30Yes (X)$0$1,086,452$17,088
Mandi Greenway Bietz MD
Dermatology40.000.00$631,312$0$46,863Yes (X)
Matthew Finke MD FACEP MPH
Emergency Medicine40.000.00$631,407$0$56,992Yes (X)
Brian Kampmann MD
Orthopedics & Sports Medicine40.000.00$1,053,377$0$53,664Yes (X)
Chris Krouse DO
Orthopedics & Sports Medicine40.000.00$1,302,660$0$46,560Yes (X)
Dennis Leland MD
General Surgery40.000.00$645,546$0$41,486Yes (X)
Thomas Clark End 122022
Former Regional President/CEO0.0040.00$0$780,573$46,532Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,744,396TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,571,215TotReportableCompRltdOrgAmt
Total Other Compensation$526,061TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K86IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Health
3900 W Avera DrSioux FallsSD57108Shared Services$12,784,881
AMN Healthcare Inc
12400 High Bluff DrSan DiegoCA92130Contract Labor$3,880,018
Journey Group
4500 W 58th StSioux FallsSD571186370Construction Services$2,386,068
Avel eCare Medical Group PC
4500 N Lewis Ave NSioux FallsSD57104eCare Services$939,929
Avera McKennan
1325 S Cliff AveSioux FallsSD57117Medical Services$713,008
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K27CntrctRcvdGreaterThan100KCnt
Related Organizations$168,553RelatedOrganizationsAmt
Government Grants$220,738GovernmentGrantsAmt
Total Contributions$389,291TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient & Resident Services621110$120,179,178$120,179,178
Patient and Clinic Revenue621110$1,731,868$1,731,868
Pharmacy Revenue456110$95,594$95,594

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,766,898TotalRevenueColumnAmt
Related Or Exempt Func Income$8,766,898RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$130,773,538TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$80,559TotalRevenueColumnAmt
Exclusion$80,559ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,528,700RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$354,746RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,173,954RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,173,954TotalRevenueColumnAmt
Exclusion$1,173,954ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$587,632SecuritiesAmt
Other$14,707OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$587,632SecuritiesAmt
Other$14,707OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$602,339TotalRevenueColumnAmt
Exclusion$602,339ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,376,467GrossSalesOfInventoryAmt
Cost Of Goods Sold$932,408CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$444,059TotalRevenueColumnAmt
Related Or Exempt Func Income$374,386RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$69,673UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
A/R Interest900099$25,688$25,688
Sports Programs900099$21,428$21,428
FieldValueIRS element (for citing)
Other Revenue Total$47,116OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$133,510,856TotalRevenueColumnAmt
Related Or Exempt Func Income$131,195,040RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$69,673UnrelatedBusinessRevenueAmt
Exclusion$1,856,852ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$42,005TotalAmt
Program Services$42,005ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$2,400TotalAmt
Program Services$2,400ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,709,315TotalAmt
Program Services$1,709,315ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$81,590TotalAmt
Program Services$81,590ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$54,051,087TotalAmt
Program Services$52,980,541ProgramServicesAmt
Management And General$1,070,546ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,037,644TotalAmt
Program Services$1,988,263ProgramServicesAmt
Management And General$49,381ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,997,150TotalAmt
Program Services$7,867,580ProgramServicesAmt
Management And General$129,570ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,448,892TotalAmt
Program Services$3,386,668ProgramServicesAmt
Management And General$62,224ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$26,128TotalAmt
Management And General$26,128ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$3,972TotalAmt
Management And General$3,972ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$22,593,575TotalAmt
Program Services$15,627,166ProgramServicesAmt
Management And General$6,955,854ManagementAndGeneralAmt
Fundraising$10,555FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,785TotalAmt
Program Services$4,456ProgramServicesAmt
Management And General$7,179ManagementAndGeneralAmt
Fundraising$150FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,123,233TotalAmt
Program Services$850,773ProgramServicesAmt
Management And General$245,760ManagementAndGeneralAmt
Fundraising$26,700FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$663,556TotalAmt
Program Services$586,081ProgramServicesAmt
Management And General$77,475ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,752,906TotalAmt
Program Services$1,641,004ProgramServicesAmt
Management And General$111,369ManagementAndGeneralAmt
Fundraising$533FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$321,253TotalAmt
Program Services$314,358ProgramServicesAmt
Management And General$6,895ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$142,220TotalAmt
Program Services$142,101ProgramServicesAmt
Management And General$119ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,208,444TotalAmt
Program Services$1,043,268ProgramServicesAmt
Management And General$165,176ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,436,021TotalAmt
Program Services$4,498,923ProgramServicesAmt
Management And General$936,908ManagementAndGeneralAmt
Fundraising$190FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$715,266TotalAmt
Program Services$296,003ProgramServicesAmt
Management And General$419,263ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies$24,502,835$24,477,214$24,388$1,233
Equipment Lease/Rental$45,065$33,208$108$11,749

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,123,565TotalAmt
Program Services$750,127ProgramServicesAmt
Management And General$365,844ManagementAndGeneralAmt
Fundraising$7,594FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$129,039,907TotalAmt
Program Services$118,323,044ProgramServicesAmt
Management And General$10,658,159ManagementAndGeneralAmt
Fundraising$58,704FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$507,428BOYAmt
EOY-$354,423EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,140,544BOYAmt
EOY$34,866,063EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,953,646BOYAmt
EOY$2,182,656EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$706,965BOYAmt
EOY$526,741EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$124,146,572LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$77,328,073LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$50,042,502BOYAmt
EOY$46,818,499EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$92,256,310BOYAmt
EOY$75,753,666EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$853,464BOYAmt
EOY$1,262,964EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,329,731BOYAmt
EOY$1,270,104EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,095,375BOYAmt
EOY$7,458,185EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$163,885,965BOYAmt
EOY$169,784,455EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,732,788BOYAmt
EOY$8,143,344EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$153,715BOYAmt
EOY$59,996EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,976,992BOYAmt
EOY$31,359,174EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$32,407BOYAmt
EOY$9,334EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,142,598BOYAmt
EOY$1,532,450EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,038,500BOYAmt
EOY$41,104,298EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$115,535,406BOYAmt
EOY$126,619,192EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,312,059BOYAmt
EOY$2,060,965EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$118,847,465BOYAmt
EOY$128,680,157EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$163,885,965BOYAmt
EOY$169,784,455EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,470,949ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,772,795NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$588,948OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,972OtherActivitiesAmt
Total Lobbying Expenditures$3,972TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAvera Queen of Peace Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,677,745BeginningYearBalanceAmt
Contributions$183ContributionsAmt
Investment Earnings Or Losses$171,141InvestmentEarningsOrLossesAmt
Other Expenditures$52,720OtherExpendituresAmt
End Year Balance$3,796,349EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,593,589BeginningYearBalanceAmt
Contributions$2,232,370ContributionsAmt
Investment Earnings Or Losses-$93,733InvestmentEarningsOrLossesAmt
Other Expenditures$54,481OtherExpendituresAmt
End Year Balance$3,677,745EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,458,737BeginningYearBalanceAmt
Contributions$125ContributionsAmt
Investment Earnings Or Losses$139,074InvestmentEarningsOrLossesAmt
Other Expenditures$4,347OtherExpendituresAmt
End Year Balance$1,593,589EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,463,190BeginningYearBalanceAmt
Contributions$3,630ContributionsAmt
Investment Earnings Or Losses-$2,991InvestmentEarningsOrLossesAmt
Other Expenditures$5,092OtherExpendituresAmt
End Year Balance$1,458,737EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,137,794BeginningYearBalanceAmt
Contributions$235,550ContributionsAmt
Investment Earnings Or Losses$97,996InvestmentEarningsOrLossesAmt
Other Expenditures$8,150OtherExpendituresAmt
End Year Balance$1,463,190EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.62266BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.21486PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.16248TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$473,670InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$2,822,681OtherCostOrOtherBasisAmt
Book Value$3,296,351BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,603,317InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$75,038,233OtherCostOrOtherBasisAmt
Depreciation$43,951,236DepreciationAmt
Book Value$32,690,314BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,551,903OtherCostOrOtherBasisAmt
Depreciation$2,071,485DepreciationAmt
Book Value$3,480,418BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$35,290,525OtherCostOrOtherBasisAmt
Depreciation$28,368,908DepreciationAmt
Book Value$6,921,617BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,366,243OtherCostOrOtherBasisAmt
Depreciation$2,936,444DepreciationAmt
Book Value$429,799BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$46,818,499TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Interest in Avera Health Foundation$4,417,477F
Interest in net assets of Mabee Trust$747,628F
Avera Pooled Investments$70,588,561F
FieldValueIRS element (for citing)
Total Book Value Securities$75,753,666TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Deferred Payroll Taxes$4,438
Derivative Liability$123,709
Estimated Third-Party Payor Settlements$468,555
Right of Use Operating Lease Obligation$906,188
Security Deposit$29,560
FieldValueIRS element (for citing)
Total Liability$1,532,450TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:The Organization holds funds in trust on behalf of its residents.
Part V, Line 4:The organization's endowments consist of a portion of their interest in the net assets of Avera Health Foundation and their beneficial interest in the Mabee Trust. Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The endowment fund assets included in the Organization's beneficial interest in the Mabee Trust have been established to purchase equipment and furnishings for the Organization. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. The Organization currently does not have any board-designated endowment funds. The endowment fund calculation was changed in current year and all amounts for prior years have been updated to properly reflect the new calculation.
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.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,086,352TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,086,352NetCommunityBenefitExpnsAmt
Total Expense0.00840TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,936,237TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,076,309DirectOffsettingRevenueAmt
Net Community Benefit Expns$859,928NetCommunityBenefitExpnsAmt
Total Expense0.00670TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,022,589TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,076,309DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,946,280NetCommunityBenefitExpnsAmt
Total Expense0.01510TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,644TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,644NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,276TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$44,276NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,116,617TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,116,617NetCommunityBenefitExpnsAmt
Total Expense0.00870TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$180,700TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$180,700NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,343,237TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,343,237NetCommunityBenefitExpnsAmt
Total Expense0.01040TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,365,826TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,076,309DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,289,517NetCommunityBenefitExpnsAmt
Total Expense0.02550TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,780TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$60,780NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$103,659TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$103,659NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,904TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,904NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$260TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$260NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$167,603TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$167,603NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$6,833,471BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$35,818,208ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$46,829,951CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$11,011,743MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities3HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDescCritical Access HospitalCriticalAccessHospitalInd
Avera Queen of Peace Hospital
1525 North Foster StreetMitchellSD57301See Part V Section C10552Yes (X)Yes (X)Yes (X)6 Provider Based Clinics
Avera Weskota Memorial Medical Center
2609 1st Street NEWessington SpringsSD57382See Part V Section C48209Yes (X)Yes (X)Yes (X)
Avera De Smet Memorial Hospital
3306 Prairie Avenue SWDe SmetSD57231See Part V Section C50726Yes (X)Yes (X)1 Provider Based ClinicYes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndPrior CHNA ImpactPriorCHNAImpactIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtOther WebsiteOtherWebsiteIndOther Website URLOtherWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndProvided Written NoticeProvidedWrittenNoticeIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndOther Actions TakenOtherActionsTakenIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndLook Back Medicare PrivateLookBackMedicarePrivateIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
Avera Queen of Peace Hospital
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V Section CYes (X)See Part V Section CYes (X)Yes (1)21Yes (1)See Part V Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Section V Part CYes (X)See Section V Part CYes (X)See Section V Part CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Weskota Memorial Medical Center
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V Section CYes (X)See Part V Section CYes (X)Yes (1)21Yes (1)See Part V Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Section V Part CYes (X)See Section V Part CYes (X)See Section V Part CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera De Smet Memorial Hospital
300Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V Section CYes (X)See Part V Section CYes (X)Yes (1)21Yes (1)See Part V Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Section V Part CYes (X)See Section V Part CYes (X)See Section V Part CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (23 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Avera Queen of Peace HospitalPart V, Section B, Line 5: The assessment process, initiated by Avera Queen of Peace, is an effort to identify significant unmet health needs in the community. The process is an opportunity to review, identify and analyze strengths and barriers to the health of the community. Mission leaders at Avera Queen of Peace collected primary data through stakeholder interviews and community surveys. Avera Queen of Peace contracted with inHealth Strategies to analyze primary data, provide technical assistance, and prepare the CHNA and implementation strategy. inHealth Strategies collected and analyzed secondary data. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations. The following organizations were represented in the process: - Mitchell Area Development Corporation - Mitchell Department of Public Safety - Mitchell Fire & Emergency Management Services (EMS) - Hanson County Sheriff's Office - Dakota Wesleyan University - Episcopal Church - Mitchell School District - Mitchell Safe House - Palace Transit, Senior Nutrition - Salvation Army - The Caring Closet - SDDOH County Health Nurse - Davison County
Avera Weskota Memorial Medical CenterPart V, Section B, Line 5: The assessment process, initiated by Avera Weskota, is an effort to identify significant unmet health needs in the community. Mission leaders at Avera Queen of Peace collected primary data through stakeholder interviews and community surveys. Avera Weskota Hospital contracted with inHealth Strategies to analyze primary data, provide technical assistance, and prepare the CHNA and implementation strategy. inHealth Strategies collected and analyzed secondary data. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations. The following organizations were represented in the process: - City of Wessington Springs - Mayor's Office/Business Owner - Jerauld County Auditor - Ministerial Association - Jerauld County Commissioner/Business Owner - South Dakota Department of Health and Human Services - Wessington Springs School District
Avera De Smet Memorial HospitalPart V, Section B, Line 5: Avera De Smet Hospital hired inHealth Strategies to conduct the focus group and analyze the results. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources, and improvements. Those providing community input were chosen for their familiarity with the needs of medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: - Inter-Lakes Community Action Partnership (ICAP) - Kingsbury County - Eastern South Dakota SHINE (seniors over 60 services) - Kingsbury County Sheriff's Department - City of De Smet - Kingsbury Court House - South Dakota Department of Social Services - De Smet United Methodist Church - American Lutheran Church, De Smet - Community Health Nurse - De Smet School District
Avera Queen of Peace HospitalPart V, Section B, Line 11: Avera Queen of Peace conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Avera Queen of Peace leadership team weighed the findings against available hospital and community resources and the likelihood that reasonable interventions would yield positive, sustainable health improvement. These criteria were used as they prioritized the significant health needs of the community.Based on the results of this assessment, Avera Queen of Peace is committed to addressing the following identified significant community health needs: Continue to explore creative solutions that remove barriers to community health needs posed by Behavioral Health and Substance Abuse issues; and Support healthy lifestyle choices to help individuals manage their weight and associated chronic diseases.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE ISSUESFY2023 Update: Avera Queen of Peace is in the process of increasing access to the three current behavioral health providers imbedded in Access Health Mitchell. Avera Queen of Peace is taking steps to increase utilization of eBehavioral Health consults in the Emergency Department. Avera Queen of Peace implemented "Ask the Question: Are you thinking about suicide" campaign into its care delivery model. Avera Queen of Peace is in the process of implementing strategies identified through the Communities that Care grant program as appropriate and feasible for Avera Queen of Peace Hospital. Avera Queen of Peace has implemented SBIRT (Screening, Brief Intervention, and Referral to Treatment) into the care delivery model in its emergency department. SBIRT is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. Avera Queen of Peace implemented the Edinburgh Scale for depression and suicide screening into the care delivery model for OB patients at Avera Queen of Peace Hospital and follow-up visits at Access Health for OB and pediatric patients. Avera Queen of Peace is working with a community group in Mitchell to create an emergent detox center. Grant applications have been submitted.HEALTHY LIFESTYLE CHOICESFY2023 Update: Preparing nutrition and wellness information to be shared at community Health Fairs. Implemented education on healthy eating as a component for wellness for those who experience chronic diseases. "Take a Bite out of Cancer: Fun Fall Snacks and Prostate Health" presented by Dr. Michael Peterson, MD; and Kat Thomsen, RDN. Primary Care Providers at Access Health in Mitchell have committed to referring patients, as appropriate, to the registered dieticians from Avera Queen of Peace Hospital for healthy choices counseling. Providers at Access Health in Mitchell are in the process of increasing the performance rate for child and adolescent weight management. Avera Medical Group opened a new clinic in Sioux Falls with a specialized focus on weight management. Primary Care Providers at Access Health in Mitchell have begun to refer patients, as appropriate, to the Avera Medical Group Comprehensive Weight Management clinic. Avera Queen of Peace is analyzing the feasibility of developing community or employee gardening plots at the Avera Queen of Peace Hospital campus. Avera Queen of Peace is taking steps to implement Good and Healthy South Dakota's Vending Munch Code to increase healthier food and drink options and selection on the Avera Queen of Peace Hospital campus.The following health needs were identified but will not be addressed: - Transportation - Affordable HousingAvera Queen of Peace does not currently have the resources to directly address the identified issues of transportation and affordable housing. However, the leadership team recognizes that the needs exist and will continue to actively participate in numerous community organizations focused on community needs and improvement.
Avera Weskota Memorial Medical CenterPart V, Section B, Line 11: Avera Weskota conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Weskota leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Weskota is committed to addressing the following identified significant community health need: *Supporting healthy lifestyle choices through education with a focus on food choices, physical activity, and stress reduction.HEALTHY LIFESTYLE CHOICESFY2023 Update: Financial support was provided for healthy snacks for students in the local school district. Weskota organized and conducted the annual fun run/walk 5K. There was an increase in participation over the prior year from the local community. Provide stress reduction education and participation activities. Developed a business plan to determine the feasibility of developing community partnerships devoted to the common needs of nutrition, activity and stress reduction.The following health need was identified but will not be addressed: *Economic stressAvera Weskota will not be directly addressing the identified issue of economic stress. While the leadership team recognizes that economic stressors exist, the hospital does not have the resources to address the issue at this time.
Avera De Smet Memorial HospitalPart V, Section B, Line 11: Avera De Smet conducted a community health needs assessment during FY2022. The prioritization process was done by the hospital administration and other healthcare professionals, along with community members serving on the new healthcare facility's fundraising committee, all of whom are highly engaged with the community and general community health needs. The process took into consideration the size of the problem (i.e., how many people does it impact,) urgency of the health need, the potential impact for the community, the feasibility of being able to address the concern and the value it would bring to the community.Based on the results of this assessment, Avera De Smet will work to address the following identified significant community health need: *Supporting healthy lifestyle choices through education with a focus on food choices, physical activity, and stress reduction.HEALTHY LIFESTYLE CHOICESFY2023 Update: Investigated the possibility of providing nutrition classes by a partnering dietician. Due to staffing shortages any local classes were not possible in 2023 but will be re-evaluted in 2024. The hospital is an active participant in a community group whose focus is to improve walking paths around the community. In 2023, we partnered with a community group focused on the creation of walking paths in the community. DeSmet took steps to identify various types of stress reduction activities that community members would be interested in participating in. We partnered with a community group that provides public education to the community. This group offered topics that fell into the nutrition and activity categories in 2023. We are annual participants in a community wide effort to bring education topics to the 65+ age group through education events in the winter months. We worked with a marketing resource to set up social media pages for the facility that will be used to promote proper nutrition, increased activity, and reduction in stress. The following health needs were identified but will not be addressed: *Behavioral Health *Substance AbuseAlthough the above needs were not selected for focus, Avera De Smet will continue to advocate for behavioral health resources and substance abuse resources in the communtiy.
Avera Queen of Peace HospitalPart 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 Weskota Memorial Medical CenterPart 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 De Smet Memorial HospitalPart 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 Queen of Peace HospitalPart 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Weskota Memorial Medical CenterPart 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera De Smet Memorial HospitalPart 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Queen of Peace HospitalPart 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. A plain language summary is offered to all uninsured patients at the time of registration.
Avera Weskota Memorial Medical CenterPart 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. A plain language summary is offered to all uninsured patients at the time of registration.
Avera De Smet Memorial HospitalPart 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. A plain language summary is offered to all uninsured patients at the time of registration.
Avera Queen of Peace HospitalPart 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 Weskota Memorial Medical CenterPart 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 De Smet Memorial HospitalPart 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 Queen of Peace Hospital Part V, Section B, Line 7a, 7b and 10c:avera.org/about/community-health-needs-assessments/#queen
Avera Weskota Memorial Medical Center Part V, Section B, Ln 7a, 7b, and 10a:avera.org/about/community-health-needs-assessments/#weskota
Avera De Smet Memorial Hospital Part V, Section B, Line 7a, 7b and 10a:avera.org/about/community-health-needs-assessments/#de-smet
Part V, Section B, Lines 16a-16cThe FAP, FAP Application, and plain language summary are available for all facilities at:avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/
Schedule H Part V, Section A organization's website:The website for Avera Queen of Peace Hospital is:avera.org/locations/queen-of-peace/The website for Avera Weskota Memorial Medical Center is:avera.org/locations/profile/avera-weskota-memorial-hospital/The website for Avera De Smet Memorial Hospital is:avera.org/locations/profile/avera-de-smet-memorial-hospital/
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Avera Brady Health and Rehab
500 S Ohman StMitchellSD57301Nursing Home
2 - Avera Brady Assisted Living
1414 W Cedar AveMitchellSD57301Assisted Living
5 - Avera Medical Group Optometry
1200 East 6th AveMitchellSD57301Clinic

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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:Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Costs of other means-tested government programs, line 7c, and subsidized health services, line 7g, were obtained from EPSi analytical reports. Community health improvement services, line 7e, Health professions education, line 7f, and cash and in-kind donations, line 7i were compiled using actual costs recorded in the CBISA software.
Part II, Community Building Activities:Avera Queen of Peace Hospital provided donations to various organizations to support activities as listed on Part II.
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 19 and 20.
Part III, Line 8:Avera Queen of Peace 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:Health care needs are assessed through various methods. Given Mitchell is a regional center/hub and the sixth largest city in South Dakota, Avera Queen of Peace is integrally involved with community organizations, universities/colleges, schools, state programs and local governments. The next largest hospital offering the same level of services is 72 miles from Mitchell and most of the towns within our region have a population of less than 2,000. By working with all in our region, we are able to determine health needs and provide programs and solutions where possible. In addition to activities reported in the Community Health Needs Assessment, Avera Queen of Peace, Avera Weskota and Avera De Smet collaborate with community health committees within their respective community to assess and promote health related matters.
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 Queen of Peace is a 25-bed critical access hospital in Mitchell, South Dakota. The primary service area is defined as Davison County, South Dakota. Mitchell is the county seat of Davison County. According to the U.S. Census Bureau Quick Facts 2021 data, the estimated population of Davison County as of July 1, 2021 is 19,878 and is predominately white at 91.9%. It is estimated that 19.9% of the population is 65 years and over. The median household income is $48,267 with a 10.7% poverty rate. Uninsured individuals under age 65 is estimated at 11.6%.
Part VI, Line 5:Avera Queen of Peace is a State Certified Level #4 Community Trauma Center and operates an emergency department staffed 24 hours per day with board certified physicians. Emergency care is provided on an open-door basis regardless of ability to pay. Avera Queen of Peace leases two critical access hospitals which provide a broad range of inpatient, outpatient services and 24-hour emergency rooms in two very rural communities.Similar to the hospitals in the Avera Queen of Peace region, the clinics are operated on an open-door basis and care is provided regardless of ability to pay.Medical staff privileges are extended to all licensed and qualified applicants. The Avera Queen of Peace Board of Directors is principally comprised of community members from the primary and secondary services areas. Members come from a variety of backgrounds including banking, education, agriculture, healthcare and private industry.
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 benefit needs. In keeping with the Catholic Healthcare 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 J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Chris Krouse DO
Orthopedics & Sports Medicine$1,109,419$0$184,701$0$8,540$0$15,250$0$31,310$0$1,349,220$0$0$0
Brian Kampmann MD
Orthopedics & Sports Medicine$1,032,673$0$15,141$0$5,563$0$15,250$0$38,414$0$1,107,041$0$0$0
Julie Lautt
CFO Avera Health;Secretary/Treasurer$0$1,075,517$0$460$0$10,475$0$15,250$0$1,838$0$1,103,540$0$0
Thomas Clark End 122022
Former Regional President/CEO$0$759,109$0$0$0$21,464$0$15,250$0$31,282$0$827,105$0$0
Douglas Ekeren
Regional President & CEO$0$686,463$0$725$0$17,002$0$15,250$0$31,182$0$750,622$0$0
Matthew Finke MD FACEP MPH
Emergency Medicine$454,260$0$143,876$0$33,271$0$15,250$0$41,742$0$688,399$0$0$0
Dennis Leland MD
General Surgery$448,316$0$184,262$0$12,968$0$15,250$0$26,236$0$687,032$0$0$0
Mandi Greenway Bietz MD
Dermatology$467,504$0$113,657$0$50,151$0$15,250$0$31,613$0$678,175$0$0$0
Jessica Claussen MD
Board Member/Opthalmology$535,202$0$15,000$0$49,785$0$15,250$0$38,900$0$654,137$0$0$0
Hilary Rockwell MD
Board Member/Emergency Medicine$419,547$0$20,881$0$2,226$0$15,250$0$51,634$0$509,538$0$0$0
Jennifer Tegethoff MD
Board Member/Pediatrics$368,674$0$65,958$0$2,821$0$15,250$0$34,160$0$486,863$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3:FormAndLineReferenceDesc
ExplanationThe President/CEO is compensated by Avera Health. Avera Queen of Peace relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonRhonda ZomerPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFamily member of board memberRelationshipDescriptionTxt
Transaction$81,590TransactionAmt
TransactionCompensation and benefits as an employeeTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Item JThe organization's website is: avera.org/locations/queen-of-peace/
Form 990, Part VI, Section A, line 2Julie Lautt, Doug Ekeren, and Thomas Clark have a business relationship.
Form 990, Part VI, Section A, line 6The 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 7aAvera 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 7bAvera 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 8bAvera Queen of Peace Hospital does not have committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe 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 12cThe conflict of interest policy covers board members, officers, and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board.
Form 990, Part VI, Section B, line 15bThe CEO and CFO-Avera Health are compensated by Avera Health. 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. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera Queen of Peace.
Form 990, Part VI, Section C, line 19The Organization's governing documents and conflict of interest policy are not available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 8,202,783. Management and general expenses 206,760. Fundraising expenses 9,304. Total expenses 8,418,847. Medical Professional Fees: Program service expenses 1,452,114. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,452,114. Repairs & Maintenance: Program service expenses 1,968,790. Management and general expenses 19,782. Fundraising expenses 1,251. Total expenses 1,989,823. Centralized Services: Program service expenses 4,003,479. Management and general expenses 6,729,312. Fundraising expenses 0. Total expenses 10,732,791.
Form 990, Part XI, line 9:Change in Beneficial Interest in Mabee Trust 3,360. Change in Fair Value of Interest Rate Swap 273,854. Change in Interest in Avera Foundation 311,734.
Form 990, Part XII, Line 2c:The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements of Avera Health, which includes Avera Queen of Peace.
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, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg, Avera at Home, and Avera Sacred Heart. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673.)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 West Avera Drive Suite 300Sioux FallsSD57108460422673Promotion of HealthSD501(c)(3)Line 10N/A0
Avera McKennan
1325 S Cliff Ave PO Box 5045Sioux FallsSD57117460224743Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera at Home
5300 S Broadband LaneSioux FallsSD57108460399291Home ServicesSD501(c)(3)Line 100Avera Health
Avera Health Plans Inc
3900 West Avera Drive Suite 101Sioux FallsSD57108460451539Health Financing and Health Plan AdminSD501(c)(4)0Avera Health
Avera Marshall
300 S Bruce StreetMarshallMN56258410919153Healthcare ServicesMN501(c)(3)Line 30Avera Health
Avera Granite Falls
345 10th AveGranite FallsMN56241843156881Healthcare ServicesMN501(c)(3)Line 30Avera Marshall
Avera Tyler
240 Willow StreetTylerMN56178410853163Healthcare ServicesMN501(c)(3)Line 30Avera Marshall
Avera St Anthony's Hospital
300 N 2nd StreetONeillNE68763470463911Healthcare ServicesNE501(c)(3)Line 30Avera Health
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera Gettysburg
606 East GarfieldGettysburgSD57442460234354Healthcare ServicesSD501(c)(3)Line 30Avera St Mary's
Avera Holy Family
826 North 8th StreetEsthervilleIA51334420680370Healthcare ServicesIA501(c)(3)Line 30Avera Health
Holy Family Hospital Foundation
826 North 8th StreetEsthervilleIA51334421317452Support Health Related ServicesIA501(c)(3)Line 100Avera Holy Family
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare ServicesSD501(c)(3)Line 30Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare ServicesSD501(c)(3)Line 100Avera Health
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare ServicesSD501(c)(3)Line 30Avera Health
St Benedict Health Center Foundation
West Glynn Drive PO Box BParkstonSD57366460458725Support Health Related ServicesSD501(c)(3)Line 12a, I0St Benedict Health Center

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 Lincoln St NELemarsIA51031820582350Medical services - home medical equipmentSDN/A00
Avera Home Medical Equipment of Lakes Regional Healthcare LLC
2301 Hwy 71 South Ste DSpirit LakeIA51360862949748Medical services - home medical equipmentIAN/A00
Avera Home Medical Equipment of Sioux Center LLC
38 19th ST SWSioux CenterIA51250753203100Medical services - home medical equipmentSDN/A00
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota Ave 102Sioux FallsSD57117800619999Medical services - home medical equipmentSDN/A00
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101BrookingsSD57006453204123Medical Services - Home Medical EquipmentSDN/A00
Caravan Health ACO 15 LLC dba Prairie Vista Care Organization
7509 NW Tiffany Springs Parkway SteKansas CityMO64153611843657Accountable Care OrganizationMON/A00
Caravan Health ACO 41 LLC dba Prairie View Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153821447782Accountable Care OrganizationMON/A00
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare servicesSDN/A00
Surgical Associates Endoscopy Clinic LLC
310 S Pennsylvania StAberdeenSD57401460461429Surgical associatesSDN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Accounts Management Inc
5132 S Cliff Ave Suite 101Sioux FallsSD57108460373021Collection agencySDN/AC0
Alucent Australia Pty Ltd
Biotech researchN/A0Level 10 30 Collings StreetMelbourneVIC 3000ASAS
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045Sioux FallsSD571175045471818349Biotech researchSDN/AC0
Avera Property Insurance Inc
1000 West 4th Street Suite 1YanktonSD57078460463155InsuranceSDN/AC0
DakotaCare Administrative Services Inc
5300 South Broadband LaneSioux FallsSD57108460424322InsuranceSDN/AC0
Dr Donald & Marguerite Mabee Trust
c/o First National Bank of South DaMitchellSD57301466056202InvestingSDTYes (1)Avera Queen of Peace Hospital$3,360$747,6281.00000
Kore Cares In Home Services LLC
5300 South Broadband LaneSioux FallsSD57108882778902In-home care servicesSDN/AS0
South Dakota State Medical Holding Inc
5300 South Broadband LaneSioux FallsSD57108460401087InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental real estateSDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule R, Part IIFormAndLineReferenceDesc
ExplanationAvera St. Benedict Foundation dissolved as of December 31, 2022.ExplanationTxt