AVERA HEALTH: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: AVERA HEALTH (EIN 46-0422673)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2023-05-12
IRS object ID: 202321329349303617
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 F
Schedule G
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-05-12T10:31:23-05:00	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	460422673	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Health	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AVER	BusinessNameControlTxt
Phone	6053227300	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3900 West Avera Drive 300	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57108	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Julie Lautt	PersonNm
Person Title	Secretary/CFO	PersonTitleTxt
Phone	6053224700	PhoneNum
Signature	2023-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	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	2023-05-08	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

Field	Value	IRS element (for citing)
Principal Officer	Bob Sutton	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3900 West Avera Drive 300	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57108	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$443,220,034	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.avera.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	2221	TotalEmployeeCnt
Total Volunteers	12	TotalVolunteersCnt
Total Gross UBI	$7,709,795	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$3,651,742	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$21,836,149	PYContributionsGrantsAmt
CY Contributions Grants	$40,871,703	CYContributionsGrantsAmt
PY Program Service Revenue	$275,697,373	PYProgramServiceRevenueAmt
CY Program Service Revenue	$274,572,116	CYProgramServiceRevenueAmt
PY Investment Income	$17,107,893	PYInvestmentIncomeAmt
CY Investment Income	$6,476,988	CYInvestmentIncomeAmt
PY Other Revenue	$8,927,575	PYOtherRevenueAmt
CY Other Revenue	$119,816,237	CYOtherRevenueAmt
PY Total Revenue	$323,568,990	PYTotalRevenueAmt
CY Total Revenue	$441,737,044	CYTotalRevenueAmt
PY Grants And Similar Paid	$30,646,490	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$15,822,920	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$194,034,408	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$171,290,281	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$2,411,449	CYTotalFundraisingExpenseAmt
PY Other Expenses	$108,462,349	PYOtherExpensesAmt
CY Other Expenses	$105,267,712	CYOtherExpensesAmt
PY Total Expenses	$333,143,247	PYTotalExpensesAmt
CY Total Expenses	$292,380,913	CYTotalExpensesAmt
PY Revenues Less Expenses	-$9,574,257	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$149,356,131	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,761,941,902	TotalAssetsBOYAmt
Total Assets EOY	$1,756,534,821	TotalAssetsEOYAmt
Total Liabilities BOY	$1,374,402,196	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,298,038,269	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$387,539,706	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$458,496,552	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Avera Health 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	Yes (1)	SignificantChangeInd
Expense	$250,585,177	ExpenseAmt
Grant	$15,822,920	GrantAmt
Revenue	$277,318,143	RevenueAmt
Desc	Avera Health is a nonprofit corporation jointly sponsored by the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota and the Benedictine Convent of the Sacred Heart of Yankton, South Dakota, together referenced as the "Sisters." Avera Health acts as the leader of the Avera health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. These organizations provide services principally in eastern South Dakota and surrounding states. Avera Health provides management consulting, fund raising and other administrative services to the hospitals, long-term health care facilities, clinics, services and programs that are sponsored or otherwise affiliated with the Sisters.During the COVID pandemic over the last three years, Avera Health and its affiliated entities have stewarded significant funding toward community benefit, from our own resources and from state and federal assistance and relief funds. When the first cases were identified in 2020, we created a 24/7 hotline people could call to inquire about testing, treatment, and later vaccination. This hotline minimized the burden of clinics and helped protect patients and the public by keeping patients from presenting to health care facilities in person. Along with the hotline, Avera launched an innovative and specialized program for caring for COVID patients at home, including daily check-ins, virtual visits (if needed) and at-home oxygen therapy. Throughout the pandemic this program has supported patients and kept hospitals from becoming overwhelmed.Additionally, we launched public awareness campaigns for masking and vaccination that included earned media, paid advertising, and digital presence. We set up testing sites and events, including a mass testing event for workers at the local protein plant. The state delegated vaccination efforts to South Dakota's health systems, and our state was recognized nationally for our "shots in arms" efficiency. Avera led efforts to prioritize those at highest risk, including not only elderly and infirm but homeless, congregate living residents and protein plant workers which included a high percentage of immigrants. We participated in national research for COVID therapies including convalescent plasma, monoclonal antibodies, and antiviral medications. We worked with local and state officials to inform the public at regular press conferences and expanded bed capacity by reallocating resources across all hospitals in our system. Avera partnered with other health facilities and systems to ensure capacity for the sickest patients, and those in need of ICU care and ventilators. Out of concern for front-line caregivers, Avera launched a Health Care Workers Stress Hotline available 24/7 for health care workers struggling with stress, anxiety, or depression as a result of effects and changes brought about by COVID-19 or other life events. Calls are answered by a behavioral health counselor. Avera also launched efforts to support and retain health care workforce, including such things as paying health insurance premiums, providing support payments, $2 across-the-board pay increases, increased on-call pay and shift differentials, and more. As pandemic-driven workforce shortages continue and inflation concerns loom, Avera has developed its own RN Travel Program to reduce dependence on costly travelers. In fact, Avera experienced traveler costs in fiscal year 2022 that were four times the cost in a typical year. Health systems across the nation are reporting financial losses due to inflation and increased labor costs, due to a highly competitive labor market. In response, Avera is making short- and long-term adjustments to optimize and control costs, hiring for critical positions only, right-sizing our organization and leveraging technology including telemedicine. We are taking these steps so that we can continue to offer essential services that people depend on throughout our region.	Desc
Total Program Service Expenses	$250,585,177	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	Yes (1)	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	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	241	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	2221	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	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
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	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	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	0	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	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	AL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	AR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	HI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MD	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NJ	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NM	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	ND	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	RI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	SC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	TN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	UT	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Jamie Schaefer	PersonNm
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 (27 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Bob Sutton
President/CEO	45.00	0.00	Yes (X)	Yes (X)	$2,049,889	$0	$51,910
Gary Gaspar-part year
Chair	5.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
Sister Penny Bingham
Vice Chair/Chair	5.00	4.00	Yes (X)	Yes (X)	$0	$0	$0
Sister Debra Kolecka OSB
Director	5.00	3.00	Yes (X)		$0	$0	$0
Dr Katherine Wang
Director	5.00	40.00	Yes (X)		$0	$560,443	$14,500
Sister Pam Donelan
Director	5.00	0.00	Yes (X)		$0	$0	$0
Dr Jason Wickersham
Director	5.00	40.00	Yes (X)		$0	$396,630	$45,414
Sister Mary Kay Panowicz
Director	5.00	1.00	Yes (X)		$0	$0	$0
Sister Roxanne Seifert
Director	5.00	5.00	Yes (X)		$0	$0	$0
Robert Fouberg
Director	5.00	0.00	Yes (X)		$0	$0	$0
Clark Sinclair
Director	5.00	0.00	Yes (X)		$0	$0	$0
Doneen Hollingsworth
Director	5.00	0.00	Yes (X)		$0	$0	$0
Dr Luis Rojas-Espaillat
Director	5.00	40.00	Yes (X)		$0	$675,592	$48,384
Lori Essig
Director	5.00	0.00	Yes (X)		$0	$0	$0
Sister Mary Jaeger PVBM
Director	5.00	0.00	Yes (X)		$0	$0	$0
Julie Lautt
CFO Avera Health; Sec/Treas	45.00	1.40		Yes (X)	$1,051,228	$0	$16,194
David Flicek
Pres/CEO - Avera McKennan	0.00	42.00			$1,291,126	$0	$45,202	Yes (X)
Tom Clark
Chief Strategy & Growth Officer	40.00	0.00			$755,081	$0	$45,202	Yes (X)
Todd Forkel
Pres/CEO - Avera St. Luke's	0.00	40.00			$721,953	$0	$40,612	Yes (X)
Doug Ekeren
President/CEO -Sacred Heart	0.00	47.00			$689,391	$0	$45,202	Yes (X)
Debbie Streier
President/CEO - Marshall	0.00	44.50			$473,161	$0	$40,327	Yes (X)
Deanna Larson - Left 112021
CEO - eCare	40.00	0.00			$862,791	$0	$35,934	Yes (X)
David Erickson
Chief Medical/Innovation Officer	40.00	4.00			$919,130	$0	$44,906		Yes (X)
Richard Korman
Senior VP - General Counsel	40.00	0.00			$796,087	$0	$45,202		Yes (X)
Kimberly Jensen
Chief Human Resource Officer	40.00	0.00			$652,362	$0	$39,636		Yes (X)
Kevin Post
Chief Medical Officer	40.00	0.00			$533,327	$0	$46,915		Yes (X)
Bruk Kammerman
Sr. VP - Chief Information Officer	40.00	0.00			$560,887	$0	$14,500		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,356,413	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,632,665	TotReportableCompRltdOrgAmt
Total Other Compensation	$620,040	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	234	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	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
CDW Government
230 N Milwaukee Ave	Vernon Hills	IL	60061	Computer Hardware; Consulting	$28,288,034
Avera McKennan
1325 S Cliff Avenue	Sioux Falls	SD	57117	Services	$7,701,163
Microsoft Corporation
1950 N Stemmons Fwy Ste 5010	Dallas	TX	75207	Software; Services	$5,104,992
Medspeed
655 West Grand Avenue	Elmhurst	IL	60126	Courier Services	$4,564,029
A3R LLC dba ViTel Net
8201 Greensboro Dr Ste 820	McLean	VA	22102	Software; Services	$3,044,058

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	139	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$287,299	FederatedCampaignsAmt
Fundraising	$1,000,328	FundraisingAmt
Related Organizations	$30,000	RelatedOrganizationsAmt
Government Grants	$1,191,544	GovernmentGrantsAmt
All Other Contributions	$38,362,532	AllOtherContributionsAmt
Noncash Contributions	$283,959	NoncashContributionsAmt
Total Contributions	$40,871,703	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
ACS revenue	900099	$230,276,502	$230,276,502
eCare revenue	900099	$19,481,474	$19,481,474
Other revenue	900099	$13,855,369	$12,745,646	$1,109,723
PACE revenue	561000	$6,700,971	$1,514,993	$5,185,978
Premier expense credits	900099	$2,884,230	$2,884,230

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,373,570	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,373,570	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$274,572,116	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$135,714	TotalRevenueColumnAmt
Exclusion	$135,714	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,830,463	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,408,092	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$422,371	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$422,371	TotalRevenueColumnAmt
Unrelated Business Revenue	$422,371	UnrelatedBusinessRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$6,341,274	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$6,341,274	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,341,274	TotalRevenueColumnAmt
Unrelated Business Revenue	$991,723	UnrelatedBusinessRevenueAmt
Exclusion	$5,349,551	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$318,504	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$1,000,328	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$74,898	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$243,606	TotalRevenueColumnAmt
Exclusion	$243,606	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Gain on sale of business unit	900099	$110,108,532	$110,108,532
A/R Interest	900099	$9,041,728		$9,041,728

Field	Value	IRS element (for citing)
Other Revenue Total	$119,150,260	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$441,737,044	TotalRevenueColumnAmt
Related Or Exempt Func Income	$277,318,143	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,709,795	UnrelatedBusinessRevenueAmt
Exclusion	$115,837,403	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$15,785,817	TotalAmt
Program Services	$15,785,817	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$37,103	TotalAmt
Program Services	$37,103	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,894,744	TotalAmt
Management And General	$7,894,744	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$135,360	TotalAmt
Program Services	$135,360	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$129,712,911	TotalAmt
Program Services	$108,975,584	ProgramServicesAmt
Management And General	$19,184,339	ManagementAndGeneralAmt
Fundraising	$1,552,988	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$7,669,185	TotalAmt
Program Services	$6,811,241	ProgramServicesAmt
Management And General	$775,023	ManagementAndGeneralAmt
Fundraising	$82,921	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$16,444,177	TotalAmt
Program Services	$13,053,497	ProgramServicesAmt
Management And General	$3,146,660	ManagementAndGeneralAmt
Fundraising	$244,020	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$9,433,904	TotalAmt
Program Services	$8,677,696	ProgramServicesAmt
Management And General	$648,535	ManagementAndGeneralAmt
Fundraising	$107,673	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$116,266	TotalAmt
Program Services	$54,716	ProgramServicesAmt
Management And General	$61,550	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,385,547	TotalAmt
Program Services	$1,385,547	ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$545,174	TotalAmt
Program Services	$545,174	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$22,562,705	TotalAmt
Program Services	$19,579,247	ProgramServicesAmt
Management And General	$2,940,853	ManagementAndGeneralAmt
Fundraising	$42,605	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$8,437,969	TotalAmt
Program Services	$8,344,211	ProgramServicesAmt
Management And General	$37,386	ManagementAndGeneralAmt
Fundraising	$56,372	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,787,187	TotalAmt
Program Services	$8,239,999	ProgramServicesAmt
Management And General	$385,442	ManagementAndGeneralAmt
Fundraising	$161,746	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$33,276,717	TotalAmt
Program Services	$32,699,823	ProgramServicesAmt
Management And General	$414,747	ManagementAndGeneralAmt
Fundraising	$162,147	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$5,547,324	TotalAmt
Program Services	$3,352,292	ProgramServicesAmt
Management And General	$2,218,639	ManagementAndGeneralAmt
Fundraising	-$23,607	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,179,078	TotalAmt
Program Services	$979,421	ProgramServicesAmt
Management And General	$185,419	ManagementAndGeneralAmt
Fundraising	$14,238	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$910,017	TotalAmt
Program Services	$795,415	ProgramServicesAmt
Management And General	$112,432	ManagementAndGeneralAmt
Fundraising	$2,170	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$659,633	TotalAmt
Program Services	$555,995	ProgramServicesAmt
Management And General	$103,638	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$20,935,576	TotalAmt
Program Services	$20,102,725	ProgramServicesAmt
Management And General	$829,695	ManagementAndGeneralAmt
Fundraising	$3,156	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	-$2,140,407	TotalAmt
Program Services	-$2,265,655	ProgramServicesAmt
Management And General	$125,248	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Repairs and maintenance	$1,365,658	$1,126,405	$239,253	$0
UBI tax	$1,351,722	$1,351,722
Lease and rental	$81,868	$56,479	$24,857	$532

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$265,678	TotalAmt
Program Services	$205,363	ProgramServicesAmt
Management And General	$55,827	ManagementAndGeneralAmt
Fundraising	$4,488	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$292,380,913	TotalAmt
Program Services	$250,585,177	ProgramServicesAmt
Management And General	$39,384,287	ManagementAndGeneralAmt
Fundraising	$2,411,449	FundraisingAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part X	Yes (X)	InfoInScheduleOPartXInd

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$28,905,697	BOYAmt
EOY	$27,501,589	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,742,261	BOYAmt
EOY	$1,609,551	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$29,283,558	BOYAmt
EOY	$37,731,747	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$396,483	BOYAmt
EOY	$11,750,560	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$15,988,570	BOYAmt
EOY	$16,146,619	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$243,613,076	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$142,216,939	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$101,695,308	BOYAmt
EOY	$101,396,137	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,294,673,040	BOYAmt
EOY	$1,292,137,490	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$148,615,736	BOYAmt
EOY	$143,843,078	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$32,516	BOYAmt
EOY	$30,792	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,139,552	BOYAmt
EOY	$16,196,061	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$124,469,181	BOYAmt
EOY	$108,191,197	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,761,941,902	BOYAmt
EOY	$1,756,534,821	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$34,826,307	BOYAmt
EOY	$33,736,130	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$6,753,531	BOYAmt
EOY	$13,064,034	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$20,936,012	BOYAmt
EOY	$18,663,217	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$1,108,976,303	BOYAmt
EOY	$1,028,211,189	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$33,371,297	BOYAmt
EOY	$19,524,946	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$169,538,746	BOYAmt
EOY	$184,838,753	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,374,402,196	BOYAmt
EOY	$1,298,038,269	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	$379,904,627	BOYAmt
EOY	$440,586,693	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,635,079	BOYAmt
EOY	$17,909,859	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$387,539,706	BOYAmt
EOY	$458,496,552	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,761,941,902	BOYAmt
EOY	$1,756,534,821	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$149,356,131	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$60,105,030	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$18,294,255	OtherChangesInNetAssetsAmt
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)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$14,467,701	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$17,411,813	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$23,574,843	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$21,836,149	CurrentTaxYearMinus1YearAmt
Current Tax Year	$40,871,703	CurrentTaxYearAmt
Total	$118,162,209	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$207,086,072	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$254,799,501	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$266,987,769	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$278,210,607	CurrentTaxYearMinus1YearAmt
Current Tax Year	$277,318,143	CurrentTaxYearAmt
Total	$1,284,402,092	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$221,553,773	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$272,211,314	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$290,562,612	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$300,046,756	CurrentTaxYearMinus1YearAmt
Current Tax Year	$318,189,846	CurrentTaxYearAmt
Total	$1,402,564,301	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$101,472	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$63,613	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$368,889	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$446,030	CurrentTaxYearMinus1YearAmt
Current Tax Year	$157,537	CurrentTaxYearAmt
Total	$1,137,541	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$130,522,462	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$166,560,168	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$178,295,346	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$177,531,681	CurrentTaxYearMinus1YearAmt
Current Tax Year	$212,485,978	CurrentTaxYearAmt
Total	$865,395,635	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$130,623,934	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$166,623,781	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$178,664,235	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$177,977,711	CurrentTaxYearMinus1YearAmt
Current Tax Year	$212,643,515	CurrentTaxYearAmt
Total	$866,533,176	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$536,031,125	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,317,953	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$157,217	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$22,385	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$199,301	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,830,463	CurrentTaxYearAmt
Total	$3,527,319	TotalAmt

Post1975 UBTI Post1975UBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$249,441	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$509,369	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,094,391	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,515,692	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,884,876	CurrentTaxYearAmt
Total	$7,253,769	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,567,394	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$666,586	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,116,776	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,714,993	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,715,339	CurrentTaxYearAmt
Total	$10,781,088	TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$309,458	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$260,272	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$369,995	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$197,164	CurrentTaxYearMinus1YearAmt
Current Tax Year	$243,606	CurrentTaxYearAmt
Total	$1,380,495	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$223,430,625	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$273,138,172	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$292,049,383	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$302,958,913	CurrentTaxYearMinus1YearAmt
Current Tax Year	$323,148,791	CurrentTaxYearAmt
Total	$1,414,725,884	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.37890	PublicSupportCY509Pct
Public Support PY509	0.39380	PublicSupportPY509Pct
Investment Income CY	0.00760	InvestmentIncomeCYPct
Investment Income PY	0.00680	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

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	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$250,000	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$17,979	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$277,195	OtherActivitiesAmt
Total Lobbying Expenditures	$545,174	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	Through paid staff and paid consultants Avera Health meets with legislators. Avera Health provides grants to other organizations for lobbying and pays dues of which a small portion is attributable to lobbying. Additionally, in FY22, Avera Health provided a grant to an organization working toward Medicaid expansion through an initiated ballot measure.	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	$7,798,048	BeginningYearBalanceAmt
Contributions	$12,909,313	ContributionsAmt
Investment Earnings Or Losses	$136,229	InvestmentEarningsOrLossesAmt
Other Expenditures	$450,181	OtherExpendituresAmt
Administrative Expenses	$43,869	AdministrativeExpensesAmt
End Year Balance	$20,349,540	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,403,165	BeginningYearBalanceAmt
Contributions	$1,694,590	ContributionsAmt
Investment Earnings Or Losses	$432,897	InvestmentEarningsOrLossesAmt
Other Expenditures	$696,359	OtherExpendituresAmt
Administrative Expenses	$36,245	AdministrativeExpensesAmt
End Year Balance	$7,798,048	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,765,277	BeginningYearBalanceAmt
Contributions	$820,309	ContributionsAmt
Investment Earnings Or Losses	$128,114	InvestmentEarningsOrLossesAmt
Other Expenditures	$273,739	OtherExpendituresAmt
Administrative Expenses	$36,796	AdministrativeExpensesAmt
End Year Balance	$6,403,165	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,295,563	BeginningYearBalanceAmt
Contributions	$392,984	ContributionsAmt
Investment Earnings Or Losses	$629,457	InvestmentEarningsOrLossesAmt
Other Expenditures	$527,554	OtherExpendituresAmt
Administrative Expenses	$25,173	AdministrativeExpensesAmt
End Year Balance	$5,765,277	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,004,011	BeginningYearBalanceAmt
Contributions	$421,937	ContributionsAmt
Investment Earnings Or Losses	$280,361	InvestmentEarningsOrLossesAmt
Other Expenditures	$386,932	OtherExpendituresAmt
Administrative Expenses	$23,814	AdministrativeExpensesAmt
End Year Balance	$5,295,563	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.23770	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.05380	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.70850	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$948,600	OtherCostOrOtherBasisAmt
Book Value	$948,600	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$31,906,474	OtherCostOrOtherBasisAmt
Depreciation	$11,825,454	DepreciationAmt
Book Value	$20,081,020	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,512,941	OtherCostOrOtherBasisAmt
Depreciation	$1,797,049	DepreciationAmt
Book Value	$715,892	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$203,294,600	OtherCostOrOtherBasisAmt
Depreciation	$128,594,436	DepreciationAmt
Book Value	$74,700,164	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,950,461	OtherCostOrOtherBasisAmt
Book Value	$4,950,461	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$101,396,137	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Interest in Innovation Institute	$13,436,326	F
Non-publicly traded hedge, private equity, debt, and multi-strategy funds	$115,323,389	F
Non-publicly traded real estate	$14,983,363	F
NPPC, LLC	$100,000	C

Field	Value	IRS element (for citing)
Total Book Value Securities	$143,843,078	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDesc	Book ValueBookValueAmt
Deferred financing costs	$15,016,088
Interest in South Dakota Community Foundation	$1,145,094
Deferred compensation	$83,376,495
Swap account	$82,125
Right of use operating lease	$6,420,860
Tax Receivable Agreement	$2,150,535

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$108,191,197	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Estimated insurance claims payable	$73,385,444
Bond interest payable	$9,208,567
Due to affiliated entities	$1,010,868
Deferred compensation	$83,376,495
Deferred payroll tax	$2,381,991
Long-term commitments	$8,951,628
Right of use lease obligations	$6,523,760

Field	Value	IRS element (for citing)
Total Liability	$184,838,753	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements.
Part V, Line 4:	The Organization's endowment consists of funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations.
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 F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean -	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$115,323,389	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$115,323,389	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$115,323,389	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (1)	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part III Accounting Method:

Form 990, Schedule F, Part IV:

Avera Health reviews its direct and indirect investments during the tax period for determining required foreign filings. The Organization's ownership interests in foreign corporations do not require a Form 5471 to be filed. The Organization invests in partnerships that hold direct or indirect interest in passive foreign investment companies. The investment partnerships have properly filed Form 8621, or the underlying investments did not generate any unrelated business income. Under these facts, Avera Health is not required to file an additional Form 8621.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Avera Race Against Cancer	Event1Nm
Gross Receipts Event1	$599,667	GrossReceiptsEvent1Amt
Charitable Contri Event1	$416,769	CharitableContriEvent1Amt
Gross Revenue Event1	$182,898	GrossRevenueEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$497	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$18,360	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$0	FoodAndBeverageEvent1Amt
Entertainment Event1	$15,090	EntertainmentEvent1Amt
Other Direct Expenses Event1	$1,965	OtherDirectExpensesEvent1Amt
Event2	Grand Give	Event2Nm
Gross Receipts Event2	$73,030	GrossReceiptsEvent2Amt
Charitable Contri Event2	$57,835	CharitableContriEvent2Amt
Gross Revenue Event2	$15,195	GrossRevenueEvent2Amt
Cash Prizes Event2	$0	CashPrizesEvent2Amt
Non Cash Prizes Event2	$0	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$740	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$2,660	FoodAndBeverageEvent2Amt
Entertainment Event2	$2,632	EntertainmentEvent2Amt
Other Direct Expenses Event2	$0	OtherDirectExpensesEvent2Amt
Other Events Total	17	OtherEventsTotalCnt
Gross Receipts Other Events	$623,037	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$511,585	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$111,452	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$0	CashPrizesOtherEventsAmt
Non Cash Prizes Other Events	$0	NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events	$3,500	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$25,624	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$2,500	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$1,330	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$1,295,734	GrossReceiptsTotalAmt
Charitable Contributions Tot	$986,189	CharitableContributionsTotAmt
Gross Revenue Total Events	$309,545	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$497	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$22,600	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$28,284	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$20,222	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$3,295	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$74,898	DirectExpenseSummaryEventsAmt
Net Income Summary	$234,647	NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (116 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
Aberdeen Catholic School Sys Inc
1400 N Dakota St	Aberdeen	SD	57401	460336005	501c3	$86,300	$0	Scholarship
Aberdeen Christian School
1500 Hwy 281 N	Aberdeen	SD	57401	911806433	501c3	$8,000	$0	Sponsorship
Aberdeen Development Corporation
506 S Main St Ste 2	Aberdeen	SD	57401	466011831	501c6	$10,000	$0	Sponsorship
Aberdeen Ride Line
205 N 4th St	Aberdeen	SD	57401	466000010	City of Aberdeen	$20,000	$0	Sponsorship
Active Generations
2300 W 46th St	Sioux Falls	SD	57105	460305500	501c3	$13,000	$0	Sponsorship
ALS Assoc MN ND SD Chapter
1919 University Ave West Ste 175	St Paul	MN	55104	411756085	501c3	$12,500	$0	Sponsorship
Alzheimers Association South Dakota
4304 S Technology Dr	Sioux Falls	SD	57106	320151779	501c3	$6,000	$0	Sponsorship
American Cancer Society
250 Williams St Nw Ste 400	Atlanta	GA	303031002	131788491	501c3	$52,500	$0	Sponsorship
American Heart Association
7272 Greenville Ave	Dallas	TX	752315129	135613797	501c3	$11,000	$0	Sponsorship
American Red Cross
2602 12th St N	Fargo	ND	58102	530196605	501c3	$10,000	$0	Sponsorship
Avera St Mary's Hospital
801 E Sioux Ave	Pierre	SD	57501	460230199	501c3	$10,000	$0	Sponsorship
Beresford School District #61-2
301 W Maple	Beresford	SD	57004	476002216	City of Beresford	$20,260	$0	Sponsorship
Bishop Dudley Hospitality House
101 N Indiana Ave	Sioux Falls	SD	57103	911836528	501c3	$21,000	$0	Sponsorship
Boy Scouts of America Sioux Council
801 N West Ave	Sioux Falls	SD	57104	460224599	501c3	$6,000	$0	Sponsorship
Boys & Girls Club of Aberdeen Area
1111 SE 1st Ave	Aberdeen	SD	57401	237062273	501c3	$29,000	$0	Sponsorship
Boys & Girls Club of Capital Area
2001 Eastgate Ave	Pierre	SD	57501	460305571	501c3	$110,000	$0	Sponsorship
Boys & Girls Clubs of Sioux Empire
100 S Spring Ave Ste 280	Sioux Falls	SD	57104	460399482	501c3	$15,000	$0	Sponsorship
Brookings School District 5-1
2130 8th St S	Brookings	SD	57006	466000834	City of Brookings	$39,307	$0	Sponsorship
Call To Freedom Inc
1915 E 8th St Ste 100	Sioux Falls	SD	57103	475469817	501c3	$27,500	$0	Sponsorship
Capital Area United Way
PO Box 1111	Pierre	SD	575011111	460403398	501c3	$5,411	$0	Sponsorship
Career & Technical Education Academy
201 E 38th St	Sioux Falls	SD	57105	466002586	City of Sioux Falls	$20,000	$0	Sponsorship
Catholic Chancery Office
523 N Duluth Ave	Sioux Falls	SD	571042714	466000424	501c3	$110,000	$0	Sponsorship
Central Lyon Community School
1010 S Greene St	Rock Rapids	IA	51246	426037624	City of Rock Rapids	$18,100	$0	Sponsorship
Charis Ministry Partners
1300 E 10th St	Sioux Falls	SD	57103	383775128	501c3	$7,000	$0	Sponsorship
Compass Center
1704 S Cleveland Ave Ste 3	Sioux Falls	SD	57103	460350199	501c3	$10,000	$0	Sponsorship
Dakota Resources
25795 475th Ave Ste 1	Renner	SD	57055	460442430	501c3	$25,000	$0	Sponsorship
Dakota State University Foundation
800 N Washington Ave	Madison	SD	570421799	466000364	501c3	$15,000	$0	Sponsorship
Dakota Wesleyan University
1200 W University Ave	Mitchell	SD	57301	460224589	501c3	$40,000	$0	Scholarship
Dakotabilities Inc
1116 S 4th Ave	Sioux Falls	SD	57105	460306216	501c3	$20,000	$0	Sponsorship
Delta Dental of SD Foundation
804 N Euclid Ste 101	Pierre	SD	57501	911776857	501c3	$20,000	$0	Sponsorship
Downtown Sioux Falls Inc
315 N Phillips Ave Ste 200	Sioux Falls	SD	57104	363627217	501c4	$6,000	$0	Sponsorship
EmBe
300 W 11th St	Sioux Falls	SD	571046306	460234998	501c3	$52,300	$0	Sponsorship
Face It Together Inc
5020 S Tennis Ln Ste 4	Sioux Falls	SD	57108	272501220	501c3	$22,500	$0	Sponsorship
Feeding South Dakota
4701 N Westport Ave	Sioux Falls	SD	571070123	363293534	501c3	$110,000	$0	Sponsorship
Fellowship of Christian Athletes
1601 E 69th St Ste 301	Sioux Falls	SD	57108	440610626	501c3	$16,500	$0	Sponsorship
Forward Sioux Falls
200 N Phillips Ave Ste 200	Sioux Falls	SD	571046058	460396647	501c6	$250,000	$0	Sponsorship
Furniture Mission of South Dakota
209 N Nesmith Ave	Sioux Falls	SD	57103	810584500	501c3	$17,500	$0	Sponsorship
Girl Scouts-Dakota Horizons
1101 S Marion Rd	Sioux Falls	SD	571063466	460250744	501c3	$6,000	$0	Sponsorship
Governor's Office of Economic Development
711 E Well Ave	Pierre	SD	57501	466000364	City of Pierre	$50,000	$0	Sponsorship
Great Plains Zoo
805 S Kiwanis Ave	Sioux Falls	SD	571043714	466015015	501c3	$60,000	$0	Sponsorship
Greater Sioux Falls Chamber of Commerce
200 N Phillips Ave Ste 200	Sioux Falls	SD	571046058	460189300	501c6	$32,750	$0	Sponsorship
Ground Works
102 N Krohns Pl Ste 113	Sioux Falls	SD	57103	475498537	501c3	$7,500	$0	Sponsorship
Harrisburg Community Foundation
PO Box 343	Harrisburg	SD	57032	841709233	501c3	$25,000	$0	Sponsorship
Helpline Center Inc
3817 S Elmwood Ave	Sioux Falls	SD	57105	237424387	501c3	$15,000	$0	Sponsorship
Hy-Vee Inc
5820 Westown Pkwy	West Des Moines	IA	502668223	420325638		$8,990	$0	Sponsorship - Great American Milk Drive
Junior Achievement of South Dakota
300 S Phillips Ave Ste L102	Sioux Falls	SD	57104	460306352	501c3	$26,000	$0	Sponsorship
Leukemia & Lymphoma Society Inc
3 International Dr Ste 200	Rye Brook	NY	10573	135644916	501c3	$25,000	$0	Sponsorship
Levitt At The Falls
524 N Main Ave 106	Sioux Falls	SD	57104	611699910	501c3	$20,000	$0	Sponsorship
LifeScape Foundation
2501 W 26th St	Sioux Falls	SD	57105	460353254	501c3	$15,000	$0	Sponsorship
Lost & Found
5015 S Crossing Pl 110	Sioux Falls	SD	57108	454306370	501c3	$10,000	$0	Sponsorship
Make-A-Wish Foundation of SD
1400 W 17th St	Sioux Falls	SD	57104	460375953	501c3	$12,500	$0	Sponsorship
Marshall Area YMCA
200 S A St	Marshall	MN	56258	411984589	501c3	$11,500	$0	Sponsorship
McCrossan Boys Ranch
47135 260th St	Sioux Falls	SD	571076428	460311913	501c3	$11,000	$0	Sponsorship
Missouri Shores Domestic Violence
PO Box 398	Pierre	SD	57501	460352133	501c3	$60,650	$0	Sponsorship
Mitchell Area Safehouse Inc
1809 N Wisconsin St	Mitchell	SD	57301	460389086	501c3	$10,000	$0	Sponsorship
Mitchell Technical College
821 N Capital St	Mitchell	SD	57301	466001338	City of Mitchell	$56,000	$0	Sponsorship
Mitchell United Way
417 N Main St Ste 103	Mitchell	SD	573010729	461250302	501c3	$7,575	$0	Sponsorship
Mount Marty University
1105 W 8th St	Yankton	SD	57078	460283336	501c3	$286,000	$0	Scholarship
NAMI of South Dakota
1601 E 69th St Ste 210	Sioux Falls	SD	57108	363593027	501c3	$35,000	$0	Sponsorship
National Kidney Foundation
30 E 33rd St Ste 100	New York	NY	10016	131673104	501c3	$15,500	$0	Sponsorship
National Multiple Sclerosis Society
733 Third Ave Flr 3	New York	NY	10017	135661935	501c3	$16,000	$0	Sponsorship
Northern State University
620 15th Ave SE	Aberdeen	SD	57401	237002314	State of SD	$152,000	$0	Scholarship
Pathways Shelter for the Homeless
412 E 4th St	Yankton	SD	57078	473974624	501c3	$7,500	$0	Sponsorship
Pierre Area Referral Service
110 W Missouri Ave	Pierre	SD	57501	460317107	501c3	$15,000	$0	Sponsorship
Pierre School District
211 S Poplar	Pierre	SD	57501	466001892	City of Pierre	$10,000	$0	Sponsorship
Presentation College
1500 N Main	Aberdeen	SD	57401	460280847	501c3	$175,000	$0	Scholarship
Presentation Sisters
1500 N 2nd St	Aberdeen	SD	57401	460253283	501c3	$25,000	$0	Sponsorship
Pride In The Tiger Foundation
400 Tiger Dr	Marshall	MN	56258	411948007	501c3	$10,000	$0	Sponsorship
Pulso Hispano
2408 E Marson Dr	Sioux Falls	SD	57103	814335278	501c3	$6,000	$0	Sponsorship
River Cities Public Transit
1600 E Dakota Ave	Pierre	SD	57501	460449059	501c3	$25,000	$0	Sponsorship
Ronald McDonald House Charities
825 S Lake Ave	Sioux Falls	SD	57104	460371152	501c3	$26,500	$0	Sponsorship
RTR Public Schools
111 County Road 8	Tyler	MN	56178	204928015	City of Tyler	$6,000	$0	Sponsorship
Safe Harbor
PO Box 41	Aberdeen	SD	57401	460344310	501c3	$11,000	$0	Sponsorship
Sculpture Walk Inc
300 S Phillips Ave Ste 104	Sioux Falls	SD	571046323	208535871	501c3	$18,000	$0	Sponsorship
SD Youth Foundation Inc
1310 Main Ave S Ste 109	Brookings	SD	57006	474832848	501c3	$10,000	$0	Sponsorship
SDSU Foundation
PO Box 525	Brookings	SD	57006	460273801	501c3	$8,000	$0	Sponsorship
Sioux Empire Baseball Assoc Inc
1321 N Cleveland Ave	Sioux Falls	SD	571036111	411903475	501c3	$30,000	$0	Sponsorship
Sioux Empire Fastpitch Softball Association
605 S Watson Ave Ste 100	Sioux Falls	SD	57108	237223489	501c3	$10,000	$0	Sponsorship
Sioux Empire United Way
1000 N West Ave 120	Sioux Falls	SD	571041332	460233701	501c3	$93,838	$0	Sponsorship
Sioux Falls Area CASA Program
100 S Spring Ave Ste 140	Sioux Falls	SD	57104	460430647	501c3	$10,000	$0	Sponsorship
Sioux Falls Area Comm Foundation
200 N Cherapa Pl	Sioux Falls	SD	57103	311748533	501c3	$66,500	$0	Sponsorship
Sioux Falls Public Schools
PO Box 560	Sioux Falls	SD	57101	263537657	City of Sioux Falls	$12,000	$0	Sponsorship
Sioux Falls School District
201 E 38th St	Sioux Falls	SD	57105	466002586	City of Sioux Falls	$10,000	$0	Sponsorship
SME Inc
PO Box 90310	Sioux Falls	SD	571090310	466012934	501c6	$8,835	$0	Sponsorship
SMSU Foundation
1501 State St	Marshall	MN	56258	237108470	501c3	$54,500	$0	Scholarship
South Dakota Agricultural and Rural
Box 2170 Animal Science Ctr 132	Brookings	SD	57007	364293293	501c3	$10,000	$0	Sponsorship
South Dakota Community Foundation
1714 N Lincoln Ave	Pierre	SD	57501	460398115	501c3	$301,628	$0	Sponsorship
South Dakota Dept of Agriculture & Natural Resources
523 E Capital Ave	Pierre	SD	57501	466000364	City of Pierre	$10,000	$0	Sponsorship
South Dakota Hall of Fame
PO Box 3649	Rapid City	SD	57701	460324210	501c3	$35,000	$0	Sponsorship
South Dakota State Medical Assoc
2600 W 49th St	Sioux Falls	SD	57105	460213945	501c6	$21,000	$0	Sponsorship
South Dakota State University
815 Medary Ave Lohr Build	Brookings	SD	57006	466000364	State of SD	$111,500	$0	Sponsorship
South Dakota State Veteran Cemetery
1714 N Lincoln Ave	Pierre	SD	57501	460398115	501c3	$50,000	$0	Sponsorship
South Dakota Symphony
301 S Main Ave 4th Flr	Sioux Falls	SD	57104	466017026	501c3	$50,000	$0	Sponsorship
Southeast Technical College
2320 N Career Ave	Sioux Falls	SD	571071302	460214496	City of Sioux Falls	$23,588	$0	Scholarship
Special Olympics South Dakota
800 E I90 Ln	Sioux Falls	SD	57104	460359776	501c3	$10,000	$0	Sponsorship
Teach for America - South Dakota Region
PO Box 398633	San Francisco	CA	941398633	133541913	501c3	$10,000	$0	Sponsorship
Teddy Bear Den
500 S Main Ave	Sioux Falls	SD	57104	311802800	501c3	$10,000	$0	Sponsorship
The Banquet
900 E 8th St	Sioux Falls	SD	57103	460387495	501c3	$7,812	$0	Sponsorship
United Way & Volunteer Services of Greater Yankton
610 W 3rd St Suite 11	Yankton	SD	57078	460252854	501c3	$13,607	$0	Sponsorship
United Way of NE SD Foundation
PO Box 1065	Aberdeen	SD	57401	421568636	501c3	$16,232	$0	Sponsorship
United Way of Southwest Minnesota
PO Box 41	Marshall	MN	562580041	416023143	501c3	$5,411	$0	Sponsorship
University of Minnesota
505 Essex St SE	Minneapolis	MN	55455	416007513	State of MN	$24,000	$0	Scholarship
University of MN Foundation Medical School Duluth Campus
1035 University Dr	Duluth	MN	55812	416042488	501c3	$24,000	$0	Scholarship
University of Sioux Falls
1101 W 22nd St	Sioux Falls	SD	57105	460224600	501c3	$400,000	$0	Sponsorship
University of South Dakota
414 E Clark St	Vermillion	SD	57069	466000364	State of SD	$273,000	$0	Scholarship
University of South Dakota Sanford School of Medicine
1400 W 22nd St	Sioux Falls	SD	571051570	466000364	State of SD	$30,000	$0	Scholarship
USD Foundation
1100 N Dakota	Vermillion	SD	57069	466018891	501c3	$15,000	$0	Scholarship
USD Gear Center
414 E Clark St	Vermillion	SD	57069	466000364	State of SD	$5,650	$0	Sponsorship
Veterans Community Project
8900 Troost Ave	Kansas City	MO	64131	474960735	501c3	$50,000	$0	Sponsorship
Vision Brookings Foundation
2301 Research Park Way Ste 113	Brookings	SD	57006	364585401	501c3	$30,000	$0	Sponsorship
Volunteers of America Dakotas
PO Box 89306	Sioux Falls	SD	57109	237353508	501c3	$41,000	$0	Sponsorship
Washington High School
201 E 38th St	Sioux Falls	SD	57105	466002586	City of Sioux Falls	$100,100	$0	Sponsorship
Washington Pavilion Management Inc
PO Box 984	Sioux Falls	SD	571010984	460435791	501c3	$77,991	$0	Sponsorship
Yankton Area Ice Association
PO Box 235	Yankton	SD	57078	752981182	501c3	$100,000	$0	Sponsorship
Yankton School District 63-3
2410 W City Limits Rd	Yankton	SD	57078	466003280	City of Yankton	$10,000	$0	Sponsorship
YMCA of Sioux Falls
220 S Minnesota	Sioux Falls	SD	57104	460225021	501c3	$10,000	$0	Sponsorship

Field	Value	IRS element (for citing)
Total501c3 Org	109	Total501c3OrgCnt
Total Other Org	7	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Medical assistance to employees	14	$27,103
Medical educational scholarships	10	$10,000

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The Organization makes grants to other organizations exempt under 501(c)(3) to ensure the funds will be used for charitable purposes. During the year ending June 30, 2022, the Organization made contributions to other non-public charities and other organizations in furtherance of community development. The contributions are approved by the Board for this purpose. Scholarship funds have different sets of criteria for determining eligibility and winners. Assistance to individuals is determined with assistance from each hospital's social services department or within a committee at the hospital.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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
Bob Sutton
President/CEO	$2,035,739	$0	$0	$0	$14,150	$0	$14,500	$0	$37,410	$0	$2,101,799	$0	$0	$0
David Flicek
Pres/CEO - Avera McKennan	$1,254,501	$0	$10,650	$0	$25,975	$0	$14,500	$0	$30,702	$0	$1,336,328	$0	$0	$0
Julie Lautt
CFO Avera Health; Sec/Treas	$1,032,072	$0	$10,440	$0	$8,716	$0	$14,500	$0	$1,694	$0	$1,067,422	$0	$0	$0
David Erickson
Chief Medical/Innovation Officer	$878,591	$0	$3,725	$0	$36,814	$0	$14,500	$0	$30,406	$0	$964,036	$0	$0	$0
Deanna Larson - Left 112021
CEO - eCare	$351,112	$0	$450,725	$0	$60,954	$0	$14,500	$0	$21,434	$0	$898,725	$0	$0	$0
Richard Korman
Senior VP - General Counsel	$770,437	$0	$10,000	$0	$15,650	$0	$14,500	$0	$30,702	$0	$841,289	$0	$0	$0
Tom Clark
Chief Strategy & Growth Officer	$726,172	$0	$10,000	$0	$18,909	$0	$14,500	$0	$30,702	$0	$800,283	$0	$0	$0
Todd Forkel
Pres/CEO - Avera St. Luke's	$713,453	$0	$0	$0	$8,500	$0	$6,948	$0	$33,664	$0	$762,565	$0	$0	$0
Doug Ekeren
President/CEO -Sacred Heart	$675,177	$0	$700	$0	$13,514	$0	$14,500	$0	$30,702	$0	$734,593	$0	$0	$0
Dr Luis Rojas-Espaillat
Director	$0	$643,523	$0	$27,000	$0	$5,069	$0	$14,500	$0	$33,884	$0	$723,976	$0	$0
Kimberly Jensen
Chief Human Resource Officer	$624,456	$0	$10,480	$0	$17,426	$0	$14,500	$0	$25,136	$0	$691,998	$0	$0	$0
Kevin Post
Chief Medical Officer	$518,571	$0	$10,240	$0	$4,516	$0	$14,500	$0	$32,415	$0	$580,242	$0	$0	$0
Bruk Kammerman
Sr. VP - Chief Information Officer	$493,130	$0	$25,000	$0	$42,757	$0	$14,500	$0	$0	$0	$575,387	$0	$0	$0
Dr Katherine Wang
Director	$0	$356,638	$0	$200,834	$0	$2,971	$0	$14,500	$0	$0	$0	$574,943	$0	$0
Debbie Streier
President/CEO - Marshall	$433,517	$0	$10,400	$0	$29,244	$0	$15,602	$0	$24,725	$0	$513,488	$0	$0	$0
Dr Jason Wickersham
Director	$0	$295,099	$0	$26,000	$0	$75,531	$0	$14,500	$0	$30,914	$0	$442,044	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 7	FormAndLineReferenceDesc
Explanation	During the current year, the organization paid certain executives incentive payments related to COVID, certain physicians retention payments, and certain staff bonuses for work on special projects. Deanna Larson received an incentive payment for the successful sale and transition of the Avel eCare service line.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VUS1	2012-05-01	$206,383,927	Series 2012B refunded 2002 and 2008A bonds issued 4/11/02 and 6/18/08	0	0	0
South Dakota Health and Educational Facilities Authority
B	460315509	83755VVY7	2014-06-26	$61,821,688	Series 2014A Various capital projects	0	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	83755VG99	2017-10-11	$242,848,916	Series 2017 refunded bond issued 6/18/08;const/equip healthcare facilities	0	0	0
South Dakota Health and Educational Facilities Authority
D	460315509	83755VJ54	2019-11-13	$50,276,218	Series 2019A refunded bond issued 4/3/2017	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$100,483,927	$206,383,927	$1,032,422	$38,100,000	$167,251,505	2013	Yes (1)	0	Yes (1)	Yes (1)
B		$61,821,688	$821,688	$61,000,000		2015	0	0	Yes (1)	Yes (1)
C	$20,688,916	$242,848,916	$1,786,422	$190,000,000	$51,062,494		0	Yes (1)	Yes (1)	Yes (1)
D		$50,276,218			$50,276,218		0	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	0	Yes (1)
B	0	0		Yes (1)
C	0	0		Yes (1)
D	0	0		Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	0	Yes (1)
C	0	0	Yes (1)
D	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Interstates Office Products Inc
Owned by board member, Gary Gaspar	$150,103	Office product purchases	0
Katherine Schild
Family member of Key Employee, Doug Ekeren	$70,464	Compensation and benefits as an employee	0
Laura Alexander
Family member of Key Employee, Doug Ekeren	$64,896	Compensation and benefits as an employee	0

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	4	ContributionCnt
Noncash Contributions Rpt F990	$88,254	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Avg of high/low	MethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	2	ContributionCnt
Noncash Contributions Rpt F990	$55,795	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	Lobby Display	1	$80,000	Cost
Yes (X)	Lights	1	$35,207	Cost
Yes (X)	Items for patients and residents	11	$17,158	Cost
Yes (X)	Auction items	1	$7,545	FMV

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Column (b):	The organization is reporting in Part I, column (b) the number of contributions.
Part I, Line 33:	Amounts included in revenue for the financial statement reporting are included on Schedule M. Additional non-cash contributions not included on Schedule M and the financial statements include items for the benefit of the Avera facilities which include special event donations.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, line 3	During the year ended June 30, 2022, Avera Health sold its telehealth division, Avel eCare LLC (Avel), and related operations to a third party. However, virtual clinical services continue to be utilized throughout the Avera footprint.
Form 990, Part VI, Section A, line 2	Julie Lautt has a business relationship with the following: Dr. Luis Rojas-Espaillat, Dr. Katherine Wang, and Dr. Jason Wickersham.
Form 990, Part VI, Section A, line 4	The Bylaws of the organization were amended in February, 2022, as follows: System Members shall consist of up to nine members (i) three Presentation Sisters or their designees appointed by the Presentation Sponsorship Members; (ii) three Benedictine Sisters or their designees appointed by the Benedictine Sponsorship Members; and (iii) up to three additional members appointed by the Sponsorship Members. At no time shall the number of designees be greater than the total number of Benedictine and Presentation Sisters. Prior to the amendment, System Members consisted of six members, including three Presentation Sisters or their designees appointed by the Presentation Sponsorship Members, and three Benedictine Sisters or their designees appointed by the Benedictine Sponsorship Members.
Form 990, Part VI, Section A, line 6	Avera Health has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of up to nine members (i) three Presentation Sisters or their designees appointed by the Presentation Sponsorship Members; (ii) three Benedictine Sisters or their designees appointed by the Benedictine Sponsorship Members; and (iii) up to three additional members appointed by the Sponsorship Members. At no time shall the number of designees be greater than the total number of Benedictine and Presentation Sisters.
Form 990, Part VI, Section A, line 7a	The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint a Benedictine Sister, Presentation Sister, or a Ministerial Juridic Person to the Boards of Directors of any sponsored work or ministry of Avera Health.
Form 990, Part VI, Section A, line 7b	The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint a Presentation Sister, a Benedictine Sister, or a Ministerial Juridic Person to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the Avera Health President; (e) To review and approve expenditures outside of the annual operating and capital budgets, for Avera Health in accordance with established Avera Health fiscal policies; (f) To review and approve the Avera Health Strategic Plan; (g) To review and approve any and all Rescript Applications on behalf of Avera Health; (h) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (i) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (j) To adopt policies designed to effectuate the powers reserved to the System Members; and (k) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members.
Form 990, Part VI, Section A, line 8b	Avera Health does not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11b	The Form 990 is reviewed by the VP of Financial Reporting, Tax Manager, and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. In FY2022, the board was provided a copy of the return with the name of a donor who wished to remain anonymous removed from Schedule B. All other aspects of the return as provided to the board mirrored the return as filed with the IRS.
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 15	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 for compensation 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.
Form 990, Part VI, Section C, line 19	The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public.
Form 990, Part VI, Section B, Line 16b:	There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.
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 Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg and Avera at Home. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).
Form 990, Part XI, line 9:	Net equity transfers 68,125. Other changes in net assets -1,795,194. Contributions received by Avera Health Foundation not reflected in financial statements -26,974,806. Grants to organizations distributed by Avera Health Foundation not reflected in financial statements 10,735,979. Net assets released from restriction -328,359.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avel eCare LLC
3900 West Avera Drive	Sioux Falls	SD	571085721	Telehealth	SD	$19,559,738	$0	Avera Health
Avel Research and Education LLC
3900 West Avera Drive	Sioux Falls	SD	571085721	Telehealth education	SD	$0	$0	Avera Health

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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare services	NE	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Holy Family
826 North 8th Street	Estherville	IA	51334	420680370	Healthcare services	IA	501(c)(3)	Line 3	Avera Health	Yes (1)
Holy Family Hospital Foundation
826 North 8th Street	Estherville	IA	51334	421317452	Support health related services	IA	501(c)(3)	Line 10	Avera Holy Family	Yes (1)
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
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	St Benedict Health Center	Yes (1)
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Queen of Peace Hospital
525 North Foster	Mitchell	SD	57301	460224604	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare services	SD	501(c)(3)	Line 3	Avera St Mary's	Yes (1)
Avera at Home
5116 S Solberg Ave	Sioux Falls	SD	57108	460399291	Home services	SD	501(c)(3)	Line 10	Avera Health	Yes (1)
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	Sacred Heart Health Services	Yes (1)
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Marshall
300 S Bruce Street	Marshall	MN	56258	410919153	Healthcare services	MN	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Tyler
240 Willow Street	Tyler	MN	56178	410853163	Healthcare services	MN	501(c)(3)	Line 3	Avera Marshall	Yes (1)
Avera Health Plans Inc
3900 West Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health financing & health plan admin	SD	501(c)(4)		Avera Health	Yes (1)
Avera Granite Falls
345 10th Ave	Granite Falls	MN	56241	843156881	Healthcare services	MN	501(c)(3)	Line 3	Avera Marshall	0

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
Surgical Associates Endoscopy Clinic LLC
310 S Penn	Aberdeen	SD	57401	460461429	Surgical associates	SD	N/A	0	0
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota Ave	Sioux Falls	SD	57117	800619999	Medical services - home medical equipment	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	Healthcare Services	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
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
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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	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	Avera Health	C	$3,339,562	$3,368,597	0.75000	Yes (1)
Avera Property Insurance Inc
1000 West 4th Street Suite 1	Yankton	SD	57078	460463155	Insurance	SD	Avera Health	C	$772,003	$1,611,691	1.00000	Yes (1)
Valley Health Services
501 Summit Street	Yankton	SD	57078	460357149	Rental real estate	SD	Sacred Heart Health Services	C	$222,180	$1,505,964	1.00000	Yes (1)
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	Biotech Research	SD	Alumend LLC	C	-$13,719,318	$13,866,434	0.65410	Yes (1)
South Dakota State Medical Holding Company Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460401087	Insurance	SD	Avera Health	C	$17,103,043	$11,431,686	1.00000	Yes (1)
DakotaCare Administrative Services Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460424322	Insurance	SD	Avera Health	C	$5,251,696	$9,318,847	1.00000	Yes (1)
Alucent Australia Pty Ltd
					Biotech Research		Alucent Biomedical Inc		-$399,015	$137,244	0.65400	Yes (1)	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	Yes (1)	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	Yes (1)	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	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	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (42 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera Health Plans Inc
K	$277,109	Vendor Payment Listing
Avera Mckennan
K	$2,303,775	Vendor Payment Listing
Accounts Management Inc
L	$490,605	General Ledger
Avera At Home
L	$4,517,833	General Ledger
Avera Health Plans Inc
L	$1,597,619	General Ledger
Avera Holy Family
L	$288,032	General Ledger
Avera Marshall
L	$14,527,164	General Ledger
Avera Mckennan
L	$147,452,037	General Ledger
Avera Queen Of Peace Hospital
L	$15,046,772	General Ledger
Avera Sacred Heart Health Services
L	$18,410,582	General Ledger
Avera St Anthony's Hospital
L	$231,543	General Ledger
Avera St Luke's
L	$21,063,130	General Ledger
Avera St Mary's
L	$11,785,101	General Ledger
St Benedict Health Center
L	$114,969	General Ledger
Avera At Home
P	$148,788	Vendor Payment Listing
Avera Health Plans Inc
P	$15,643,068	Vendor Payment Listing
Avera Holy Family
P	$74,367	Vendor Payment Listing
Avera Marshall
P	$269,026	Vendor Payment Listing
Avera Mckennan
P	$19,801,608	Vendor Payment Listing
Avera Queen Of Peace Hospital
P	$117,501	Vendor Payment Listing
Avera Sacred Heart Health Services
P	$459,230	Vendor Payment Listing
Avera St Luke's
P	$786,297	Vendor Payment Listing
Accounts Management Inc
Q	$291,046	Customer Invoice Listing
Avera At Home
Q	$3,607,861	Customer Invoice Listing
Avera Health Plans Inc
Q	$105,942	Customer Invoice Listing
Avera Holy Family
Q	$1,658,986	Customer Invoice Listing
Avera Marshall
Q	$10,011,374	Customer Invoice Listing
Avera Mckennan
Q	$114,191,190	Customer Invoice Listing
Avera Queen Of Peace Hospital
Q	$12,873,317	Customer Invoice Listing
Avera Sacred Heart Health Services
Q	$15,461,764	Customer Invoice Listing
Avera St Anthony's Hospital
Q	$4,146,288	Customer Invoice Listing
Avera St Luke's
Q	$6,339,135	Customer Invoice Listing
Avera St Mary's
Q	$6,226,325	Customer Invoice Listing
St Benedict Health Center
Q	$2,600,018	Customer Invoice Listing
Avera At Home
R	$404,114	General Ledger
St Benedict Health Center
R	$81,411	General Ledger
Avera St Luke's
R	$133,448	General Ledger
Avera St Mary's
R	$2,071,925	General Ledger
Avera Mckennan
R	$4,637,110	General Ledger
Avera Queen Of Peace Hospital
R	$79,613	General Ledger
Avera St Anthony's Hospital
R	$85,000	General Ledger
Avera Sacred Heart Health Services
R	$332,804	General Ledger

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part I:	FormAndLineReferenceDesc
Explanation	Avel eCare, LLC was sold effective November 2021.	ExplanationTxt