2025-05-14T14:17:42-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 460224598 Avera St Luke's AVER 6056225272 305 South State Street Aberdeen SD 57401 Julie Lautt CFO Avera Health 6056225272 2025-05-09 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-04-22 2023 2025-03-06 01:10:19Z Daniel Bjerknes 305 South State Street Aberdeen SD 57401 208985079 0 0928 X See Schedule O X 1901 SD Promotion of health 15 10 1306 22 -180695 0 720538 569579 196613050 196779327 191456 570203 2603735 -777696 200128779 197141413 13020 11569 0 0 111776241 111805521 0 0 3814 97383165 87997915 209172426 199815005 -9043647 -2673592 155386406 150122754 76429350 72116047 78957056 78006707 X Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. 0 0 185755251 11569 196381277 Avera St. Luke's mission is to provide healthcare services to Aberdeen, South Dakota residents and residents of the surrounding area. Avera St. Luke's is a 501(c)(3) organization affiliated with Avera Health. Avera St. Luke's consists of 50 acute beds, 10 inpatient behavioral health beds, an 81-bed nursing home in Aberdeen, SD, a 56-bed nursing home in Eureka, SD, a 2-bed surgical center in Aberdeen, SD, and 18 physician clinics. The physician clinics include primary care, ob/gyn, pediatrics, orthopedics, general surgery, radiation, radiology, oncology, therapy, urology, hematology, psychiatry, pulmonology, nephrology, podiatry, ear nose and throat, pain management, and cardiology. Avera St. Luke's provides acute care and long-term healthcare services. Avera St. Luke's Hospital 3,658 Acute patient discharges 367 Newborn patient discharges 38 Swing bed patient discharges 153,025 Outpatient visits 300 Swing-bed patient days 614 Newborn patient days 148,921 Clinic visits 46,530 Nursing home resident days 116 Long Term Care patient dischargesAvera St. Luke's maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $33,361,688.Avera St. Luke's also provides community benefit health activities at less than or at no cost to support those in the area served, see Schedule H. As a member of the Avera Health Network, Avera St. Luke's upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera St. Luke's engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. 185755251 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 144 0 1 1306 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 10 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 1 1 0 X X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Daniel Bjerknes President/CEO 40.00 0.00 X X 0 503084 50471 Heidi Golz Chair 1.00 0.00 X X 0 0 0 Michael Herman Vice Chair 1.00 0.00 X X 0 0 0 Sr Kathleen Bierne Board Member 1.00 0.00 X 0 0 0 Kristen Fauth Board Member 1.00 0.00 X 0 0 0 Shane Franks Board Member 1.00 0.00 X 0 0 0 John Fritz MD Board Member 1.00 0.00 X 0 0 0 Richard Inman Board Member 1.00 0.00 X 0 0 0 Paula Jensen Board Member 1.00 0.00 X 0 0 0 Sr Marietta Kerkvliet Board Member 1.00 0.00 X 0 0 0 Adam LeFebvre MD Board Member/Anesthesiology 41.00 0.00 X 518726 0 50241 Sr Mary Kay Panowicz Board Member 1.00 5.00 X 0 0 0 Diana Reynen Board Member 1.00 0.00 X 0 0 0 Thomas Seyer Board Member 1.00 0.00 X 0 0 0 Garrett Wobst MD Board Member/Orthopedics/Surgery 41.00 0.00 X 625813 0 44459 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1203675 19401 Tom J Snyder VP - Strategy Network Ops (End 03/2024) 40.00 0.00 X 222455 0 28549 Brandon Fites MD Sports Medicine, Surgery & Orthopedics 40.00 0.00 X 2999342 0 53017 Daniel Fritz MD Radiology 40.00 0.00 X 1242294 0 39997 Ryan Gnesda MD Radiology 40.00 0.00 X 1477815 0 53521 Susheel Gundewar MD Cardiology 40.00 0.00 X 1913170 0 59633 Leslie Lenter MD Interventional Radiology & Radiology 40.00 0.00 X 1550096 0 41735 10549711 1706759 441024 137 0 1 0 Avera Health 3900 W Avera Dr Ste 301 Sioux Falls SD 571085721 Shared services 17456804 AMN Healthcare Inc 12400 High Bluff Dr San Diego CA 92130 Contract labor 5862582 ProLink Healthcare LLC 10700 Montgomery Rd Ste 226 Cincinnati OH 45242 Contract labor 1049945 Concord Physician Solutions LLC 5900 Balcones Dr Ste 8686 Austin TX 78731 Locum Fees 987472 Huff Construction Inc 11 N Dakota St Aberdeen SD 57401 Construction 952964 36 168249 401330 569579 Net Patient Revenue 621110 190905715 190363557 542158 Patient and Clinic Revenue 621110 1523151 1523151 Investment in Partnership 900099 807716 807716 3542745 3542745 196779327 301384 301384 419286 618237 -198951 -198951 -198951 304763 0 35944 304763 -35944 268819 268819 10374037 11189485 -815448 -92595 -722853 A/R Interest Income 900099 236703 236703 236703 197141413 196381277 -180695 371252 X 11569 11569 1401017 1217575 183442 1356158 1356158 89475385 87843669 1631716 2938807 2875121 63686 11378712 11084405 294307 5255442 5142796 112646 24941 24941 5603 5603 39048895 29383842 9664620 433 17923 11774 6149 1351125 1144170 205614 1341 731746 731636 60 50 2252454 2049159 203295 375208 354503 20705 284188 273484 10704 2366899 1952128 414771 6396312 5908674 486940 698 974970 414725 560245 Medical Supplies 32662571 32612520 49098 953 Equipment Lease/Rental 192816 192816 Provision for income ta 60000 60000 Bad Debt 5012 5012 1247252 1129515 117398 339 199815005 185755251 14055940 3814 41670 -16557 28031852 23439653 5028788 4113300 1034330 891585 191903983 130285541 63914775 61618442 12871473 16494586 1367227 1446442 41350782 41108248 1745509 1027055 155386406 150122754 14608812 13271564 111876 0 60470223 57980674 16964 16682 1221475 847127 76429350 72116047 X 75841229 74275235 3115827 3731472 78957056 78006707 155386406 150122754 X -2673592 846646 876597 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5603 5603 0 Part II-B, Line 1: Avera St. Luke's paid dues to organizations which have a portion attributable to lobbying activities. 0 1 X 1545178 158364 44083 1659459 1465145 100544 20511 1545178 1635977 -170630 202 1465145 1391327 244663 13 1635977 1407609 -5119 11163 1391327 0.39585 0.33755 0.26660 0 1 1 1115700 4653892 5769592 134526798 89816075 44710723 48216225 38589260 9626965 3391368 1880206 1511162 61618442 Avera Pooled Investments 11168656 F Investment in Avera Health Foundation 4926228 F Investment in Subsidiaries 399702 F 16494586 Estimated Third Party Payor Settlements 397564 Derivative Liability 279707 Right of Use Operating Lease Obligations 116756 Security Deposits 53100 847127 X Part IV, Line 2b: The organization holds funds in trust on behalf of its residents. Part V, Line 4: The Organization's endowments consist of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. 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 financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 8703657 0 8703657 0.04360 16524354 13099983 3424371 0.01710 268559 106014 162545 0.00080 25496570 13205997 12290573 0.06150 53451 53451 0.00030 6710431 3513799 3196632 0.01600 1825908 42399 1783509 0.00890 8589790 3556198 5033592 0.02520 34086360 16762195 17324165 0.08670 25867 25867 0.00010 65 65 0.00000 25932 25932 0.00010 1 0 58404672 68189435 -9784763 X 1 1 1 Surgical Associates Endoscopy Clinic LLC Endoscopy Procedures 0.51000 0.49000 1 1 Avera St Luke's 305 South State Street Aberdeen SD 57401 See Part V Section C 10525 X X X 14 provider based clinics, 1 rural health clinic Avera St Luke's 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V Section C X See Part V Section C X 1 21 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V Section C X See Part V Section C X See Part V Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Avera St. Luke's Part V, Section B, Line 5: Avera St. Luke's CHNA data was obtained by way of an online survey that launched on April 7, 2022. This was followed by personal meetings with our Public Health providers, as well as emails and communications to regional and community organizations and the public inviting their participation in the survey. The survey was also posted to and available through Avera St. Luke's Facebook page. The survey closed April 15, 2022. The hospital invited a vast array of groups and approximately 80 businesses in Aberdeen and the surrounding area to participate, which included: *Aberdeen Chamber of Commerce, which included the survey in their Monday morning Chamber email *Aberdeen Chamber committees *Aberdeen Area Fire and Rescue *Social Work Department, which sent the survey to all the organizations and food banks they work with such as the Salvation Army and Journey Home*Mission and Chaplaincy, which forwarded on to all area priests in our region *Boys and Girls Club families *United Way, which sent it to organizations and board members *Aberdeen City Council *City of Aberdeen via its Human Resource Department *Brown County Health*ASL employees *ASL Facebook page, which is open to the public *ASL Patient and Family Advisory Committee *Presentation Sisters*Aberdeen Area Diversity Coalition Avera St. Luke's Part V, Section B, Line 11: The Community Health Needs Assessment survey was completed in FY2022. An internal team at Avera St. Luke's reviewed survey results and identified the top three health needs from the survey. This decision was based on the severity of the issue, our current involvement in these areas, and our professional outlook. Our overall focus is to review these opportunities and identify current programs already in place that will address the following health needs: Mental Health issues, Hospice and End of Life Care, and Access to Care/Urgent Care. 1. Mental Health: Avera St. Luke's completed the building project for a stand-alone behavioral health facility. This expansion will create growth for the system and meets the needs of the region. The Avera Behavioral Health Unit offers inpatient and outpatient counseling and therapy services, grief support services, memory care, and behavioral health support groups. The facility treats many mental health conditions, including anxiety, depression, bipolar disorder, conduct disorder, interpersonal problems, oppositional defiant disorder, personality disorders, psychosis, schizophrenia, and attention deficit hyperactivity disorder (ADHD). The Behavioral Health team has established successful ongoing partnerships that have provided high-quality care and decreased health disparities within this highly rural area. The Behavioral Health Unit treats both adults and adolescents in a unit consisting of 10 psychiatric beds. Avera Behavioral Health Unit has a demonstrated ability to and history of serving this target population, and successfully partnering with regional organizations like those proposed. Currently, the 4th floor is being renovated to move our Behavioral Health Services from its current location in Aberdeen, SD expanding from a 10-bed unit to an 18-bed unit. 2. Hospice Care: Our organization has been working on expanding our hospice beds in our community, as reflected as a need from our community needs health assessment. Partnering with Avera@Home, we are now able to offer inpatient hospice services at Avera St Luke's as of October of 2023. Three hospice rooms added at Avera Mother Joseph Manor LTC opened December 2023. 3. Access to Care/Urgent Care: We've expanded Urgent Care January 2024 and the Same Day Clinic has seen 894 patients through the end of June. The hours for the Same Day Clinic are Monday - Thursday 8am-5pm and Friday 8am-12pm. Our After-hours services expanded on Fridays from 1pm-7pm beginning in January of 2024 and have since seen 728 additional patients to date. The hours for the After-hours services are Monday - Thursday 5pm-7pm, Friday 1pm-7pm, and Saturday - Sunday 8am-2pm.There are needs identified in the Community Health Needs Assessment which Avera St. Luke's has not included in its priority implementation plan. These needs were not included in the priority needs implementation plan in order to focus resources on the three most urgent health care needs. We continue to address these needs throughout the Avera St. Luke's Region using the appopriate standards of care. Avera St. Luke's Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. Avera St. Luke's Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and is included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. Avera St. Luke's Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. Avera St. Luke's Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. Part V, Section A organization's website: avera.org/locations/st-lukes-hospital/ Part V, Section B, Line 7a, 7b and 10a: avera.org/about/community-health-needs-assessments/ Part V, Section B, Line 16a, 16b, and 16c: avera.org/patients-visitors/pay-my-bill-online/financial-assistance-forms/ 5 1 - Avera Mother Joseph Manor 1002 N Jay Street Aberdeen SD 57401 Nursing Home, Assisted and Congregate Living 2 - Avera Eureka Health Care Center E Hwy 10 Eureka SD 57437 Skilled Nursing Facility 3 - AMG Pain Management Center 701 8th Ave NW Ste C Aberdeen SD 57401 Clinic 4 - NSU Health Services 1200 S Jay St Aberdeen SD 57401 Clinic 5 - AMG Oncology and Hematology 310 S Penn St Ste 106 Aberdeen SD 57401 Clinic Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 6a: The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/. Part I, Line 7: A combination of costing methodologies were used to calculate the amounts reported in the table. A cost-to-charge ratio derived from Worksheet 2, ratio of patient care cost-to-charges was used to calculate charity care at cost, unreimbursed Medicaid and Means-Tested Government Program expenses. Subsidized health was calculated based on actual cost/loss. For all other amounts, costs and revenues as reflected by the general ledger system were used. Part II, Community Building Activities: Avera St. Luke's donated to the Aberdeen Parks Recreation & Forestry to create an outdoor fitness space within Kuhnert Arboretum. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. During the year ended June 30, 2024, the Organization adjusted the qualifying criteria under the charity care policy, which resulted in a reclassification of accounts considered bad debt in previous years that now qualified as presumptive charity care under the adjusted policy. Implicit price concession for the year of $1,888,099 was reduced for prior year reclassifications of $25,581,173 resulting in a net negative implicit price concession of $23,693,074. Due to the negative implicit price concession per the general ledger, an amount of $0 has been reported on Line 2. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 19 and 20. Part III, Line 8: Avera St. Luke's provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. Medicare allowable costs of care are based on the FY2023 Medicare cost report. The FY2023 Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. Part VI, Line 2: Health Care needs are assessed through various methods. Given Aberdeen is a regional center/hub and the third largest city in South Dakota, Avera St. Luke's is integrally involved with community organizations, universities/colleges, schools, state programs and local governments. Although another smaller hospital opened in Aberdeen during FY 2013, the next largest hospital is 100 miles from Aberdeen, and most of the towns within our region have a population of less than 2,000. By working with all in our region, we are able to determine health needs and provide programs and solutions where possible. Our fourth community health needs assessment (CHNA) was completed and posted to our website by June 30, 2022. The identified areas of need highlighted for further research and comparison are Mental Health issues, Hospice and End of Life Care and lastly Access to Care. The overall goal is to focus on removing all barriers to health. Part VI, Line 3: Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs. Part VI, Line 4: Avera St Luke's includes a 50-bed hospital and a 10-bed mental health unit in Aberdeen, South Dakota. The primary service area is defined as Brown County, South Dakota, including the communities of Aberdeen, Frederick, Groton, Hecla, and Leola. Brown County is the focus of the Avera St. Luke's Community Health Needs Assessment. The total population estimate as of July 1, 2023, is 37,733, which places it as the fourth largest county in South Dakota. Brown County is also the most populated county in the Avera St. Luke's service area. 52% of residents served are between the ages of 18 and 64. 88.3% of Brown County's population consists of people who are of White Ethnicity. Brown County has seen an increase of people from other ethnic backgrounds. Because we are all created in God's image and belong to the same human family, Avera has worked hard to meet the growing need to address complex issues within our footprint. Through our system initiatives, Avera St. Luke's is committed to evaluating the health needs and priorities of all members of our community without regard to race or ethnicity. Programs and support are added to address the identified needs as appropriate. The unemployment rate in South Dakota is at 2.0% while the rate in Brown County is at 1.7%, both of which are better than the national average of 4.2%. According to the U.S. Census Bureau Quick Facts as of July 1, 2023 the income per capita for the county is $38,035 and the median household income is $70,379. However, the rate of persons below the poverty level in Brown County is 11.0%. Approximately 9.9% of the county's population is uninsured, while the State average is 10%. Although Brown County's numbers are slightly better than the state and national statistics in these categories, Avera has identified opportunities. Part VI, Line 5: Avera St. Luke's is a regional facility within Avera Health System. Each year, our operating and capital budgets are based on various assumptions that in the end provide the needed resources and considers charity care, patient care, technology, education, community services, employee benefit, and compensation plans and programs for meeting the region's needs. All surplus funds are used and maintained to provide for both current and future needs.Specific examples of how we further our exempt purpose include but are not limited to the following: a. The only inpatient psychiatric unit within 200 miles. b. Interventional Cardiology and Radiology services. These services allow us to meet patient needs when care is critical to their survival and must be delivered on a very timely basis. c. Air Ambulance to transport patients to our facility or 200 miles to tertiary facilities. d. End Stage Renal Disease program which serves our broad region with the next closest facility being 100 miles away. Additionally, we employ a part-time Nephrologist to care for the patients along with others who require intensive physician care. e. A 24-hour Emergency Room which treats all patients without regard to the ability to pay. The ER is staffed by physicians 24 hours per day. f. Provision of a multitude of educational and training programs for healthcare professionals and regional residents. The region was awarded an Area Health Education Center by the South Dakota School of Medicine and will be in Aberdeen. The award was based on applications and interviews within the State and was a collaborative effort of many healthcare and non-healthcare organizations within the region with two being 100 miles from Aberdeen. g. Avera St. Luke's is currently a Rural Referral Center. The nearest hospitals are tertiary facilities 200 miles away by ground and approximately 140 miles by air. h. Avera St. Luke's participates in many community organizations and efforts to better the region. Leadership of the organization is on boards of many exempt organizations (Aspire Foundation Board, College/University Advisory Boards, Area Health Education Center (AHEC), United Way and the YMCA). In conjunction with Aspire and the South Dakota Department of Vocational Rehabilitation, Avera St. Luke's participates in Project SEARCH, providing internships for high school students with disabilities in their last year of high school and assists in helping students attain work skills and prepare them for a job. Other community involvement includes National Night Out focusing on child safety, Junior Achievement, Northern Brown County Community Foundation, Diversity Committee, Aberdeen Hockey Association, Aberdeen Wings Billet Family, Aberdeen Downtown Association, Frederick Forward, LSS Board member, Aberdeen Development Corporation Board member, American Foundation for Suicide Prevention, and CoJourner for the Presentation Sisters (Lay Associate). i. Aid small rural hospitals (Critical Access Hospitals) within the region through various programs, management agreements, computer systems, education, and other services to assist in keeping their area's patients in the local community when possible. j. Recruitment of specialists in nephrology, neurology, cardiology, family medicine, orthopedic, pulmonology, radiation, oncology, pediatrics, general surgery, urology, rheumatology, internal medicine, and psychiatry to meet the region's needs in order to eliminate travel of 200 miles to obtain these services. k. Development and subsidy of various rural clinics to meet needs in those communities. l. Chemical Addiction services on an outpatient basis are provided to the region and State. Our Addiction Care program is well known and respected within the region and state and is the closest program within 150-200 miles. We contract with the State for patients who meet their qualification guidelines and work with governmental agencies within the region and State. m. Provide drug and alcohol prevention programs to the local schools through various contracts. Our involvement started when the previous provider discontinued their contract. Part VI, Line 6: Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance. 1 Redfield Community Memorial PO Box 288 Redfield SD 57469 460433111 501(c)(3) 10000 0 Donation to EMS Center 1 0 Part I, Line 2: The organization provides grants/contributions to other organizations which are tax-exempt under IRC 501(c)(3) and governmental divisions that benefit the community and region through programs and activities. 0 0 0 0 0 0 0 0 0 Brandon Fites MD Sports Medicine, Surgery & Orthopedi 2118832 0 874360 0 6150 0 16500 0 36517 0 3052359 0 0 0 Susheel Gundewar MD Cardiology 1580220 0 330182 0 2768 0 16500 0 43133 0 1972803 0 0 0 Leslie Lenter MD Interventional Radiology & Radiology 798083 0 731713 0 20300 0 16500 0 25235 0 1591831 0 0 0 Ryan Gnesda MD Radiology 842714 0 633488 0 1613 0 16500 0 37021 0 1531336 0 0 0 Daniel Fritz MD Radiology 523626 0 717591 0 1077 0 15729 0 24268 0 1282291 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0 1197590 0 480 0 5605 0 16500 0 2901 0 1223076 0 0 Garrett Wobst MD Board Member/Orthopedics/Surgery 452214 0 172438 0 1161 0 16500 0 27959 0 670272 0 0 0 Adam LeFebvre MD Board Member/Anesthesiology 487103 0 30400 0 1223 0 16500 0 33741 0 568967 0 0 0 Daniel Bjerknes President/CEO 0 498188 0 0 0 4896 0 16500 0 33971 0 553555 0 0 Tom J Snyder VP - Strategy Network Ops (End 03/20 220149 0 900 0 1406 0 11291 0 17259 0 251005 0 0 0 Schedule J, Part I Line 3: The President/CEO was compensated by a related organization, Avera Health. Avera St. Luke's relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. Dr Matthew Reynen Family member of board member Diana Reynen 556300 Compensation and benefits as an employee 0 Daniel Fritz Family member of board member John Fritz 463572 Compensation and benefits as an employee 0 Bari Fritz Family member of board member John Fritz 247487 Compensation and benefits as an employee 0 Karin Bruns Family member of board member Garrett Wobst 88802 Compensation and benefits as an employee 0 Form 990, Item J The organization's website is: avera.org/locations/st-lukes-hospital/ Form 990, Part VI, Section A, line 2 Julie Lautt, Daniel Bjerknes, and Sr. Mary Kay Panowicz have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the board of directors. Form 990, Part VI, Section A, line 7b Avera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. Form 990, Part VI, Section B, line 15b The CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera St. Luke's. Form 990, Part VI, Section C, line 19 The organization's governing documents and conflict of interest policy are not available to the general public. The organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public. Form 990, Part IX, line 11g Purchased Services: Program service expenses 12,416,258. Management and general expenses 392,673. Fundraising expenses 97. Total expenses 12,809,028. Medical Professional Fees: Program service expenses 4,876,477. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,876,477. Repairs & Maintenance: Program service expenses 3,782,447. Management and general expenses 14,248. Fundraising expenses 336. Total expenses 3,797,031. Centralized Services: Program service expenses 8,308,660. Management and general expenses 9,257,699. Fundraising expenses 0. Total expenses 17,566,359. Form 990, Part XI, line 9: Change in Interest in Avera Foundation 736,784. Equity Transfers 139,813. Form 990, Part XII, Line 2c: The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements for Avera Health, which includes Avera St. Luke's. Form 990, Part VI, Section B, Line 16b: There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. Form 990, Part X, Line 20: The issue price includes the filing organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera 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). Avera Health 3900 West Avera Drive Suite 300 Sioux Falls SD 57108 460422673 Promotion of health SD 501(c)(3) Line 10 N/A 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera at Home 5300 S Broadband Lane Sioux Falls SD 57108 460399291 Home services SD 501(c)(3) Line 10 Avera Health 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing and health plan admin SD 501(c)(4) Avera Health 0 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 0 Avera Granite Falls 345 10th Ave Granite Falls MN 56241 843156881 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Queen of Peace Hospital 525 North Foster Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare services NE 501(c)(3) Line 3 Avera Health 0 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 0 Holy Family Hospital Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Lewis and Clark Health Education and Service Agency 1000 W 4th Street Suite 9 Yankton SD 57078 460337013 Healthcare services SD 501(c)(3) Line 10 Avera Health 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Home Medical Equipment of Floyd Valley Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 820582350 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Lakes Regional Healthcare LLC 5300 S Broadband Lane Sioux Falls SD 57108 862949748 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Sioux Center LLC 5300 S Broadband Lane Sioux Falls SD 57108 753203100 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Spencer Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 800619999 Medical services - home medical equipment SD N/A 0 0 Brookings Health System - Avera Home Medical Equipment LLC 300 22nd Ave Brookings SD 57006 453204123 Medical services - home medical equipment SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 611843657 Accountable care organization TX N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 821447782 Accountable care organization TX 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 Surgical Associates Endoscopy Center LLC 310 S Pennsylvania Street Suite 201 Aberdeen SD 57401 460461429 Surgical Associates/ Endoscopy Services SD Avera St Luke's Related 1006437 280789 1 0 0.51000 Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection agency SD N/A C 0 Alucent Australia Pty Ltd Level 10 30 Collings Street Melbourne VIC 3000 AS Biotech Research AS N/A 0 Alucent Biomedical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 Avera Property Insurance Inc 1000 West 4th Street Suite 1 Yankton SD 57078 460463155 Insurance SD N/A C 0 DakotaCare Administrative Services Inc 5300 South Broadband Lane Sioux Falls SD 57108 460424322 Insurance SD N/A C 0 Kore Cares In Home Services LLC 5300 South Broadband Lane Sioux Falls SD 57108 882778902 In-home care services SD N/A S 0 South Dakota State Medical Holding Company Inc 5300 South Broadband Lane Sioux Falls SD 57108 460401087 Insurance SD N/A C 0 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Rental Real Estate SD N/A C 0 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Surgical Associates Endoscopy Clinic LLC A 108723 General Ledger Surgical Associates Endoscopy Clinic LLC L 172022 General Ledger Surgical Associates Endoscopy Clinic LLC O 327406 General Ledger Surgical Associates Endoscopy Clinic LLC P 58800 General Ledger Surgical Associates Endoscopy Clinic LLC S 822500 K-1 Distribution