AVERA QUEEN OF PEACE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- AVERA QUEEN OF PEACE (EIN 46-0224604)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202321329349302982
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T10:31:03-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460224604 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 6059952251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 6059952251 | PhoneNum |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Julie | PersonFirstNm |
| Person Last | Lautt | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2023-05-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace Health Service | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Douglas Ekeren | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $151,241,530 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | See Schedule O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 853 | TotalEmployeeCnt |
| Total Volunteers | 34 | TotalVolunteersCnt |
| Total Gross UBI | $157,334 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,715,446 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,002,542 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $120,596,238 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $127,612,680 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,184,931 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,461,910 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,381,367 | PYOtherRevenueAmt |
| CY Other Revenue | $1,117,133 | CYOtherRevenueAmt |
| PY Total Revenue | $133,877,982 | PYTotalRevenueAmt |
| CY Total Revenue | $134,194,265 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $14,848 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $32,479 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $65,328,474 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $67,453,045 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $34,973 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $55,328,253 | PYOtherExpensesAmt |
| CY Other Expenses | $59,879,470 | CYOtherExpensesAmt |
| PY Total Expenses | $120,671,575 | PYTotalExpensesAmt |
| CY Total Expenses | $127,364,994 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $13,206,407 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,829,271 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $173,794,004 | TotalAssetsBOYAmt |
| Total Assets EOY | $163,885,965 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $50,831,034 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $45,038,500 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $122,962,970 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $118,847,465 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $115,305,369 | ExpenseAmt |
| Grant | $32,479 | GrantAmt |
| Revenue | $127,578,049 | RevenueAmt |
| Desc | Avera 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 50 acute beds and a 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 10 physician clinics. The physician clinics include primary care, OB/GYN, pediatrics, orthopedics, general surgery, internal medicine, radiation, radiology, oncology, dermatology, therapy, 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 Hospital1,691 Acute patient discharges459 Newborn patient discharges60 Swing Bed patient discharges100,780 Outpatient visits642 Swing-bed patient days862 Newborn patient days92,305 Clinic visitsAvera Brady Health and Rehabilitation93 Long Term Care patient discharges21,916 Long-term care resident daysAvera Weskota Memorial Medical Center (CAH)60 Acute patient discharges37 Swing Bed discharges4,789 Outpatient visits368 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH)61 Acute patient discharges17 Swing Bed patient discharges13,065 Outpatient visits119 Swing-bed patient days3,955 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 $2,069,042.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 | $115,305,369 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 100 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 853 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jamie Schaefer | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6053223992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3900 W Avera Dr Ste 300 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Hilary Rockwell MD | ||||||||||
| Board Member/Physician | 42.00 | 0.00 | Yes (X) | $441,549 | $0 | $51,691 | ||||
| Ryan Huber | ||||||||||
| Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Jay Tolsma | ||||||||||
| Vice Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Sister Kathleen Bierne | ||||||||||
| Board Member | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sister Erin Colgan | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Jason Bradley | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Julie Brookbank | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Quinten Burg - Left 52022 | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Brad Zomer | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Ryan Thompson | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Jean Koehler | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gopal Vyas | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Mark Hunhoff | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Tracey Larson | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Douglas Ekeren | ||||||||||
| Regional President | 5.00 | 42.00 | Yes (X) | $0 | $689,391 | $45,202 | Yes (X) | |||
| Jennifer Tegethoff MD | ||||||||||
| Board Member/Pediatrics | 42.00 | 0.00 | Yes (X) | $440,020 | $0 | $48,164 | ||||
| Jessica Claussen MD | ||||||||||
| Board Member/Opthalmology | 42.00 | 0.00 | Yes (X) | $602,331 | $0 | $52,904 | ||||
| Darleen Bergeleen-Joined 52022 | ||||||||||
| Board Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Julie Lautt | ||||||||||
| CFO Avera Health; Sec/Treas | 0.10 | 46.30 | $0 | $1,051,228 | $16,194 | Yes (X) | ||||
| Rochelle Reider | ||||||||||
| VP Patient Services | 40.00 | 0.00 | $199,587 | $0 | $34,681 | Yes (X) | ||||
| Brian Kampmann MD | ||||||||||
| Orthopedics, Sports Medicine | 40.00 | 0.00 | $1,025,734 | $0 | $52,190 | Yes (X) | ||||
| Chris Krouse DO | ||||||||||
| Orthopedics, Sports Medicine | 40.00 | 0.00 | $1,249,480 | $0 | $45,414 | Yes (X) | ||||
| Mandi Greenway Bietz MD | ||||||||||
| Dermatology | 40.00 | 0.00 | $591,701 | $0 | $45,317 | Yes (X) | ||||
| Thad Kandel MD | ||||||||||
| General Surgery | 40.00 | 0.00 | $575,829 | $0 | $26,144 | Yes (X) | ||||
| Dennis Leland MD | ||||||||||
| General Surgery | 40.00 | 0.00 | $635,424 | $0 | $40,436 | Yes (X) | ||||
| Thomas Clark | ||||||||||
| Former Regional President/CEO | 0.00 | 40.00 | $0 | $755,081 | $45,202 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,761,655 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,495,700 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $503,539 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 81 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Health | |||||
| 3900 W Avera Dr | Sioux Falls | SD | 57108 | Shared Services | $13,580,587 |
| Avera McKennan | |||||
| 1325 S Cliff Ave | Sioux Falls | SD | 57117 | Medical Prof., Interpreter, Printing | $2,408,082 |
| Sioux Falls Construction Co | |||||
| 4500 W 58th St | Sioux Falls | SD | 571186370 | Construction Services | $1,319,498 |
| AMN Healthcare Inc | |||||
| 12400 High Bluff Dr | San Diego | CA | 92130 | Contract Labor | $1,275,167 |
| Medical Information Technology | |||||
| Meditech Cir | Westwood | MA | 02090 | Information Technology Services | $779,506 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $80,887 | RelatedOrganizationsAmt |
| Government Grants | $3,916,418 | GovernmentGrantsAmt |
| All Other Contributions | $5,237 | AllOtherContributionsAmt |
| Total Contributions | $4,002,542 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient & Resident Services | 622110 | $116,266,832 | $116,266,832 | |
| Retail Pharmacy | 900099 | $1,104,307 | $946,973 | $157,334 |
| Cafeteria | 900099 | $294,565 | $294,565 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,946,976 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,946,976 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $127,612,680 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,530,289 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $535,859 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $994,430 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $994,430 | TotalRevenueColumnAmt |
| Exclusion | $994,430 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $17,973,316 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,506,413 | SecuritiesAmt |
| Other | $4,993 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,466,903 | SecuritiesAmt |
| Other | -$4,993 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,461,910 | TotalRevenueColumnAmt |
| Exclusion | $1,461,910 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Operating Interest | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $122,703 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $122,703 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $122,703 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $134,194,265 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $127,578,049 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $157,334 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,456,340 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,479 | TotalAmt |
| Program Services | $32,479 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,775,074 | TotalAmt |
| Program Services | $1,651,377 | ProgramServicesAmt |
| Management And General | $123,697 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,951 | TotalAmt |
| Program Services | $63,951 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,953,977 | TotalAmt |
| Program Services | $50,990,138 | ProgramServicesAmt |
| Management And General | $963,839 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,814,088 | TotalAmt |
| Program Services | $2,754,839 | ProgramServicesAmt |
| Management And General | $59,249 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,523,438 | TotalAmt |
| Program Services | $7,421,661 | ProgramServicesAmt |
| Management And General | $101,777 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,322,517 | TotalAmt |
| Program Services | $3,258,162 | ProgramServicesAmt |
| Management And General | $64,355 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,996 | TotalAmt |
| Management And General | $3,996 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $838 | TotalAmt |
| Management And General | $838 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,825,154 | TotalAmt |
| Program Services | $16,971,831 | ProgramServicesAmt |
| Management And General | $7,831,079 | ManagementAndGeneralAmt |
| Fundraising | $22,244 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,582 | TotalAmt |
| Program Services | $11,000 | ProgramServicesAmt |
| Management And General | $10,665 | ManagementAndGeneralAmt |
| Fundraising | $2,917 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,183,558 | TotalAmt |
| Program Services | $925,422 | ProgramServicesAmt |
| Management And General | $252,320 | ManagementAndGeneralAmt |
| Fundraising | $5,816 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,344,435 | TotalAmt |
| Program Services | $544,907 | ProgramServicesAmt |
| Management And General | $799,528 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,761,340 | TotalAmt |
| Program Services | $1,658,688 | ProgramServicesAmt |
| Management And General | $102,652 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,836 | TotalAmt |
| Program Services | $315,532 | ProgramServicesAmt |
| Management And General | $21,304 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,092 | TotalAmt |
| Program Services | $114,178 | ProgramServicesAmt |
| Management And General | $1,914 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,114,679 | TotalAmt |
| Program Services | $959,401 | ProgramServicesAmt |
| Management And General | $155,278 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,388,414 | TotalAmt |
| Program Services | $4,761,732 | ProgramServicesAmt |
| Management And General | $626,492 | ManagementAndGeneralAmt |
| Fundraising | $190 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,612 | TotalAmt |
| Program Services | $277,086 | ProgramServicesAmt |
| Management And General | $482,526 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $21,938,504 | $21,910,865 | $25,947 | $1,692 |
| Equipment Lease/Rental | $33,593 | $33,056 | $537 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,047,837 | TotalAmt |
| Program Services | $649,064 | ProgramServicesAmt |
| Management And General | $396,659 | ManagementAndGeneralAmt |
| Fundraising | $2,114 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,364,994 | TotalAmt |
| Program Services | $115,305,369 | ProgramServicesAmt |
| Management And General | $12,024,652 | ManagementAndGeneralAmt |
| Fundraising | $34,973 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,512 | BOYAmt |
| EOY | $507,428 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,433 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,048,599 | BOYAmt |
| EOY | $15,140,544 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,788,336 | BOYAmt |
| EOY | $1,953,646 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,510 | BOYAmt |
| EOY | $706,965 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $123,876,161 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $73,833,659 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,670,655 | BOYAmt |
| EOY | $50,042,502 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,227,015 | BOYAmt |
| EOY | $92,256,310 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,330 | BOYAmt |
| EOY | $853,464 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,400,988 | BOYAmt |
| EOY | $1,329,731 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,748,626 | BOYAmt |
| EOY | $1,095,375 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,794,004 | BOYAmt |
| EOY | $163,885,965 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,748,937 | BOYAmt |
| EOY | $8,732,788 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,148 | BOYAmt |
| EOY | $153,715 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,503,413 | BOYAmt |
| EOY | $31,976,992 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,190 | BOYAmt |
| EOY | $32,407 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,557,346 | BOYAmt |
| EOY | $4,142,598 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,831,034 | BOYAmt |
| EOY | $45,038,500 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,201,188 | BOYAmt |
| EOY | $115,535,406 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,761,782 | BOYAmt |
| EOY | $3,312,059 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,962,970 | BOYAmt |
| EOY | $118,847,465 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,794,004 | BOYAmt |
| EOY | $163,885,965 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,829,271 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$11,945,082 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,000,306 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $838 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $838 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Avera Queen of Peace Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $774,913 | BeginningYearBalanceAmt |
| Contributions | $2,232,370 | ContributionsAmt |
| Investment Earnings Or Losses | $11,866 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,684 | GrantsOrScholarshipsAmt |
| Other Expenditures | $63,133 | OtherExpendituresAmt |
| End Year Balance | $2,954,332 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $742,586 | BeginningYearBalanceAmt |
| Contributions | $125 | ContributionsAmt |
| Investment Earnings Or Losses | $36,549 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,609 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,738 | OtherExpendituresAmt |
| End Year Balance | $774,913 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $726,701 | BeginningYearBalanceAmt |
| Contributions | $3,630 | ContributionsAmt |
| Investment Earnings Or Losses | $17,348 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,093 | OtherExpendituresAmt |
| End Year Balance | $742,586 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $708,556 | BeginningYearBalanceAmt |
| Contributions | $356 | ContributionsAmt |
| Investment Earnings Or Losses | $25,945 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $8,156 | OtherExpendituresAmt |
| End Year Balance | $726,701 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,748,708 | BeginningYearBalanceAmt |
| Contributions | $424 | ContributionsAmt |
| Investment Earnings Or Losses | $37,389 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,077,965 | OtherExpendituresAmt |
| End Year Balance | $708,556 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.20040 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.05050 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.74910 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $473,670 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,822,681 | OtherCostOrOtherBasisAmt |
| Book Value | $3,296,351 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,621,915 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $71,686,533 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,115,390 | DepreciationAmt |
| Book Value | $31,193,058 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,483,721 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,782,225 | DepreciationAmt |
| Book Value | $3,701,496 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,782,854 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,108,164 | DepreciationAmt |
| Book Value | $7,674,690 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,004,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,827,880 | DepreciationAmt |
| Book Value | $4,176,907 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $50,042,502 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Interest in Avera Health Foundation | $5,690,635 | F |
| Interest in net assets of Mabee Trust | $744,269 | F |
| Avera Pooled Investments | $85,821,406 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $92,256,310 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Derivative Liability | $397,564 |
| Deferred Payroll Taxes | $886,957 |
| Right of Use Operating Lease Obligation | $1,190,075 |
| Estimated Third-Party Payor Settlements | $1,668,002 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,142,598 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $556,624 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $556,624 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,493,027 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,100,653 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,392,374 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01880 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $149,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $120,681 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,845 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,199,177 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,221,334 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,977,843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $575 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,920 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,920 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,025,670 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,025,670 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $145,561 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,561 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,200,726 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,200,726 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,399,903 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,221,334 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,178,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03280 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,168 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,968 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $672 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $672 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,808 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,808 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,919,855 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $33,767,804 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,200,998 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,433,194 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 3 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (3 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | |||||||||||
| 1 | 525 North Foster Street | Mitchell | SD | 57301 | See Part V Section C | 10552 | Yes (X) | Yes (X) | Yes (X) | 8 Provider Based Clinics | |
| Avera Weskota Memorial Medical Center | |||||||||||
| 2 | 609 1st Street NE | Wessington Springs | SD | 57382 | See Part V Section C | 48209 | Yes (X) | Yes (X) | Yes (X) | ||
| Avera De Smet Memorial Hospital | |||||||||||
| 3 | 306 Prairie Avenue SW | De Smet | SD | 57231 | See Part V Section C | 50726 | Yes (X) | Yes (X) | 1 Provider Based Clinic | Yes (X) | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Other WebsiteOtherWebsiteInd | Other Website URLOtherWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Other CriteriaOtherCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP TranslatedFAPTranslatedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Other Actions TakenOtherActionsTakenInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Look Back Medicare PrivateLookBackMedicarePrivateInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 21 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V Section C | Yes (X) | See Part V Section C | Yes (X) | Yes (1) | 21 | Yes (1) | See Part V Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (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 C | Yes (X) | See Section V Part C | Yes (X) | See Section V Part C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Weskota Memorial Medical Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 21 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V Section C | Yes (X) | See Part V Section C | Yes (X) | Yes (1) | 21 | Yes (1) | See Part V Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (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 C | Yes (X) | See Section V Part C | Yes (X) | See Section V Part C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera De Smet Memorial Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 3 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 21 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V Section C | Yes (X) | See Part V Section C | Yes (X) | Yes (1) | 21 | Yes (1) | See Part V Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (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 C | Yes (X) | See Section V Part C | Yes (X) | See Section V Part C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Avera Queen of Peace Hospital | Part 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 Center | Part 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 Hospital | Part 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 Hospital | Part 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.The following actions will be taken in future years to address the identified and prioritized community health needs:Behavioral Health and Substance Abuse issues *Increase access to the three current behavioral health providers imbedded in Access Health Mitchell. *Increase utilization of eBehavioral Health consults in the Emergency Department. *Implement the Avera's "Ask the Question: Are you thinking about suicide" campaign in the Avera facilities in the Avera Queen of Peace region. *Implement strategies identified through the Communities that Care grant program as appropriate and feasible for Avera Queen of Peace Hospital. *Implement SBIRT (Screening, Brief Intervention, and Referral to Treatment) in the Avera Queen of Peace Hospital emergency department. SBIRT is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. *Implement the Edinburgh Scale for depression and suicide screening for OB patients at Avera Queen of Peace Hospital and follow-up visits at Access Health for OB and pediatric patients.Healthy Lifestyle Choices *Provide nutrition and wellness information at the Health Fairs Avera Queen of Peace attends. *Provide annual education and/or cooking demonstrations on healthy eating as a component for wellness for those who experience chronic diseases. *Primary Care Providers at Access Health in Mitchell commit 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 commit to 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 commit to referring patients, as appropriate, to the Avera Medical Group Comprehensive Weight Management clinic. *Analyze the feasibility of developing community or employee gardening plots at the Avera Queen of Peace Hospital campus. *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 Queen of Peace continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.BEHAVIORAL HEALTH AND SUBSTANCE ABUSEBehavioral health was identified as an area of need that Avera Queen of Peace is addressing. Access to services, early intervention, and education are critical to achieving positive outcomes for individuals and communities. The hospital has developed the following goals to address this need. -Increase psychology appointments; increase appointments with LCSW-Increase PHQ-9 screening follow-up appointments in ambulatory settings-Decrease average score on PHQ-9 screenings in in-patient settings-Decrease behavioral health crisis ED visits -Increase the number of Avera eBehavioral encountersFY 2022 - The number of psychologist appointments continues to increase. Over the past two years, the number of appointments has increased more than 127%.FY 2022 - Avera Queen of Peace continues to offer behavioral health services through telehealth services. Avera Queen of Peace also prioritized increasing behavioral health screenings in clinical workflows, particularly the use of the PHQ-9 tool in ambulatory settings.TRANSPORTATIONAnother need continuing to rise to the top of the community health needs is the need for affordable and reliable on-demand transportation. The need exists within city limits and between towns and cities for all citizens as the need to get to and from school, work, and medical appointments. Avera Queen of Peace has developed the following goals to address this need.-Create resource list/algorithm on transportation options for all relevant staff-Evaluate number of rides paid for by the AQOP Foundation-Evaluate the number of conversations AMG-Care Coordination is having with patients about transportation needs-Increase the number of those enrolled in mail-order pharmacyFY2022 - Avera Queen of Peace built a list of transportation resources. The is posted for employees to reference and use to help patients with transportation needs. Avera Queen of Peace also pursued strategies to lessen the number of trips individuals needed to take for services and supplies. Avera Queen of Peace continues to enroll patients in and fill scripts through the mail-order pharmacy. The mail-order pharmacy volume has remained relatively constant.AFFORDABLE HOUSINGGood health is dependent upon adequate housing, providing dwellers a sense of privacy, security, stability, and control. A minimum of 12 of every 100 households in the county is at risk for health issues such as infectious disease and poor childhood development due to the severe cost burden of housing. Avera Queen of Peace had started a project with the City of Mitchell for the construction of affordable housing on land that Avera Queen of Peace donated. FY 2022 Update: Avera Queen of Peace Hospital does not currently have the resources to address the issues related to affordable housing. However, the 21.7 acre parcel of land donated to the City of Mitchell is still available for an affordable housing development. Avera Queen of Peace Hospital will continue to actively participate in community organizations that address housing issues. |
| Avera Weskota Memorial Medical Center | Part 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.The following actions will be taken in future years to address the identified and prioritized community health need:*Provide nutrition education to the community through strategic partnerships. - Provide annual education on healthy nutrition choices. - Provide financial or like support for programs impacting the nutritional options for the students in the Weskota School District.*Provide physical activity education to the community through strategic partnerships. - Organize the annual fun run/walk 5K. - Encourage campus-wide participation in physical activity challenges through the LiveNow Avera series.*Provide stress reduction education to the community through strategic partherships. - Provide stress reduction education and participation activities.*Develop 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 Weskota continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.FURTHER COMMUNITY HEALTH EDUCATION-Increase collaboration with Horizon Healthcare on community health education-Increase educational posts on FacebookFY 2022 - Avera Weskota Memorial Medical Center continued to work with Horizon on our community health wellness and education efforts.REMOVE BARRIERS TO PRIMARY CARE ACCESS-Increase access to primary care services through hiring of additional primary care providersFY 2022 - Avera Weskota continues to look for opportunities to add healthcare services and upgrade equipment to provide patients with a greater level of comfort and accuracy in their health care. |
| Avera De Smet Memorial Hospital | Part 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.The following actions will be taken in future years to address the identified and prioritized community health need:*Provide nutrition education to the community through strategic partnerships.*Provide physical activity education to the community through strategic partnerships. -Provide annual education on increasing physical activity -Encourage campus-wide participation in physical activity*Provide stress reduction education to the community through strategic partnerships.*Develop 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 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 community.Avera De Smet continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.REMOVE BARRIERS TO SKILLED HOME HEALTH CARE ACCESS-Increase Avera@Home Home Health patients-Increase the number of Avera@Home Home Health patients using lab servicesFY 2022 - Avera DeSmet Memorial Hospital has continued to collaborate with Avera at Home to enhance continuity of care and improve access to healthcare in the community. - Provide education and marketing materials for patients-Provide Avera@Home access to community resource informationFY 2022 - Marketing and education materials continue to be distributed to patients in both print and digital forms. Avera De Smet continues to provide topical health and wellness material to promote health and wellness in the community. |
| Avera Queen of Peace 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 Weskota Memorial Medical Center | 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 De Smet Memorial 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 Queen of Peace 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Weskota Memorial Medical Center | 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera De Smet Memorial 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Queen of Peace 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera Weskota Memorial Medical Center | 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera De Smet Memorial 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera Queen of Peace 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 Weskota Memorial Medical Center | 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 De Smet Memorial 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 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-16c | The 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/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Avera Brady Health and Rehab | ||||
| 500 S Ohman St | Mitchell | SD | 57301 | Nursing Home |
| 2 - Avera Brady Assisted Living | ||||
| 1414 W Cedar Ave | Mitchell | SD | 57301 | Assisted Living |
| 5 - Avera Medical Group Optometry | ||||
| 1200 East 6th Ave | Mitchell | SD | 57301 | Clinic |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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 a 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 50-bed 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 I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Dakota Wesleyan University | ||||||||
| 1200 W University Ave | Mitchell | SD | 57301 | 460224589 | 501(c)(3) | $8,000 | $0 | Assistance to DWU Athletics |
| Avera Health Foundation | ||||||||
| 3900 W Avera Dr Ste 300 | Sioux Falls | SD | 57108 | 460422673 | 501(c)(3) | $8,640 | $0 | Speech therapy funding assistance for children |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The organization provides grants/contributions to other organizations which are tax-exempt under IRS Section 501(c)(3) and governmental divisions that benefit the community and region through programs and activities. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chris Krouse DO | ||||||||||||||
| Orthopedics, Sports Medicine | $1,062,406 | $0 | $177,376 | $0 | $9,698 | $0 | $14,500 | $0 | $30,914 | $0 | $1,294,894 | $0 | $0 | $0 |
| Brian Kampmann MD | ||||||||||||||
| Orthopedics, Sports Medicine | $1,001,501 | $0 | $16,500 | $0 | $7,733 | $0 | $14,500 | $0 | $37,690 | $0 | $1,077,924 | $0 | $0 | $0 |
| Julie Lautt | ||||||||||||||
| CFO Avera Health; Sec/Treas | $0 | $1,032,072 | $0 | $10,440 | $0 | $8,716 | $0 | $14,500 | $0 | $1,694 | $0 | $1,067,422 | $0 | $0 |
| Thomas Clark | ||||||||||||||
| Former Regional President/CEO | $0 | $726,172 | $0 | $10,000 | $0 | $18,909 | $0 | $14,500 | $0 | $30,702 | $0 | $800,283 | $0 | $0 |
| Douglas Ekeren | ||||||||||||||
| Regional President | $0 | $675,177 | $0 | $700 | $0 | $13,514 | $0 | $14,500 | $0 | $30,702 | $0 | $734,593 | $0 | $0 |
| Dennis Leland MD | ||||||||||||||
| General Surgery | $501,317 | $0 | $120,530 | $0 | $13,577 | $0 | $14,500 | $0 | $25,936 | $0 | $675,860 | $0 | $0 | $0 |
| Jessica Claussen MD | ||||||||||||||
| Board Member/Opthalmology | $535,302 | $0 | $15,937 | $0 | $51,092 | $0 | $14,500 | $0 | $38,404 | $0 | $655,235 | $0 | $0 | $0 |
| Mandi Greenway Bietz MD | ||||||||||||||
| Dermatology | $467,904 | $0 | $72,382 | $0 | $51,415 | $0 | $14,500 | $0 | $30,817 | $0 | $637,018 | $0 | $0 | $0 |
| Thad Kandel MD | ||||||||||||||
| General Surgery | $501,640 | $0 | $11,250 | $0 | $62,939 | $0 | $14,500 | $0 | $11,644 | $0 | $601,973 | $0 | $0 | $0 |
| Hilary Rockwell MD | ||||||||||||||
| Board Member/Physician | $416,629 | $0 | $21,482 | $0 | $3,438 | $0 | $14,500 | $0 | $37,191 | $0 | $493,240 | $0 | $0 | $0 |
| Jennifer Tegethoff MD | ||||||||||||||
| Board Member/Pediatrics | $369,374 | $0 | $32,078 | $0 | $38,568 | $0 | $14,500 | $0 | $33,664 | $0 | $488,184 | $0 | $0 | $0 |
| Rochelle Reider | ||||||||||||||
| VP Patient Services | $195,826 | $0 | $285 | $0 | $3,476 | $0 | $10,154 | $0 | $24,527 | $0 | $234,268 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Rhonda Zomer | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family member of board member | RelationshipDescriptionTxt |
| Transaction | $63,951 | TransactionAmt |
| Transaction | Compensation and benefits as an employee | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Item J | The organization's website is: avera.org/locations/queen-of-peace/ |
| Form 990, Part VI, Section A, line 2 | Julie Lautt, Doug Ekeren and Thomas Clark 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 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 11b | The Form 990 is reviewed by the Avera Health VP of Financial Reporting, Tax Manager, Facility CEO and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers board members, officers, and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. |
| Form 990, Part VI, Section B, line 15b | The CEO 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 19 | The 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 11g | Purchased Services: Program service expenses 9,038,304. Management and general expenses 233,008. Fundraising expenses 22,244. Total expenses 9,293,556. Repairs and Maintenance: Program service expenses 1,732,582. Management and general expenses 19,555. Fundraising expenses 0. Total expenses 1,752,137. Medical Prof Fees: Program service expenses 1,692,245. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,692,245. Centralized Services: Program service expenses 4,508,700. Management and general expenses 7,578,516. Fundraising expenses 0. Total expenses 12,087,216. |
| Form 990, Part XI, line 9: | Change in Beneficial Interest in Mabee Trust -137,085. Change in Interest in Avera Foundation -163,762. Change in Fair Value of Interest Rate Swap 571,173. Equity Transfers 729,980. |
| 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 VI, Section B, Line 16b: | There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. |
| Form 990, Part X, Line 20: | The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera 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/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 West Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of Health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera St Anthony's Hospital | |||||||||||
| 300 N 2nd Street | ONeill | NE | 68763 | 470463911 | Healthcare Services | NE | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Holy Family | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare Services | IA | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Holy Family Hospital Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support Health Related Services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family | |
| Avera Marshall | |||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 410919153 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| St Benedict Health Center | |||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| St Benedict Health Center Foundation | |||||||||||
| West Glynn Drive PO Box B | Parkston | SD | 57366 | 460458725 | Support Health Related Services | SD | 501(c)(3) | Line 12a, I | 0 | St Benedict Health Center | |
| Avera McKennan | |||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460224743 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Mary's | |||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera at Home | |||||||||||
| 5116 S Solberg Ave | Sioux Falls | SD | 57108 | 460399291 | Home Services | SD | 501(c)(3) | Line 10 | 0 | Avera Health | |
| 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 | 0 | Sacred Heart Health Services | |
| Avera St Luke's | |||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Tyler | |||||||||||
| 240 Willow Street | Tyler | MN | 56178 | 410853163 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Health Plans Inc | |||||||||||
| 3900 West Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health Financing and Health Plan Admin | SD | 501(c)(4) | 0 | Avera Health | ||
| Avera Granite Falls | |||||||||||
| 345 10th Ave | Granite Falls | MN | 56241 | 843156881 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | |||||||||
| 714 Lincoln St NE | Lemars | IA | 51031 | 820582350 | Medical services - home medical equipment | SD | N/A | 0 | 0 |
| Avera Home Medical Equipment of Sioux Center LLC | |||||||||
| 38 19th ST SW | Sioux Center | IA | 51250 | 753203100 | Medical services - home medical equipment | SD | N/A | 0 | 0 |
| Avera Home Medical Equipment of Spencer Hospital LLC | |||||||||
| 2400 S Minnesota Ave 102 | Sioux Falls | SD | 57117 | 800619999 | Medical services - home medical equipment | SD | N/A | 0 | 0 |
| Surgical Associates Endoscopy Clinic LLC | |||||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | Surgical associates | SD | N/A | 0 | 0 |
| Heart Hospital of South Dakota LLC | |||||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare services | SD | N/A | 0 | 0 |
| Brookings Health System - Avera HME LLC | |||||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 |
| Caravan Health ACO 41 LLC dba Prairie View Care Organization | |||||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 821447782 | Accountable Care Organization | MO | N/A | 0 | 0 |
| Caravan Health ACO 15 LLC dba Prairie Vista Care Organization | |||||||||
| 7509 NW Tiffany Springs Parkway Ste | Kansas City | MO | 64153 | 611843657 | Accountable Care Organization | MO | N/A | 0 | 0 |
| Avera Home Medical Equipment of Lakes Regional Healthcare LLC | |||||||||
| 2301 Hwy 71 South Ste D | Spirit Lake | IA | 51360 | 862949748 | Medical services - home medical equipment | IA | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | ||||||||||||||||||
| 5132 S Cliff Ave Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection agency | 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 | |||||||||
| Dr Donald & Marguerite Mabee Trust | ||||||||||||||||||
| c/o First National Bank of South Da | Mitchell | SD | 57301 | 466056202 | Investing | SD | T | Yes (1) | Avera Queen of Peace Hospital | -$137,085 | $744,269 | 1.00000 | ||||||
| Valley Health Services | ||||||||||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | Rental real estate | SD | N/A | C | 0 | |||||||||
| Alucent Biomedical Inc | ||||||||||||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | Biotech research | SD | N/A | C | 0 | |||||||||
| South Dakota State Medical Holding Inc | ||||||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460401087 | 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 | |||||||||
| Alucent Australia Pty Ltd | ||||||||||||||||||
| Biotech research | N/A | 0 | Level 10 30 Collings Street | Melbourne | VIC 3000 | AS | AS | |||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |