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AVERA MCKENNAN: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
AVERA MCKENNAN (EIN 46-0224743)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-12
IRS object ID
202341329349303674
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-12T10:32:52-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN460224743EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera McKennanBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone6053228000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11325 South Cliff AveAddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP571175045ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJulie LauttPersonNm
Person TitleCFO - Avera HealthPersonTitleTxt
Phone6053228000PhoneNum
Signature2023-05-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJuliePersonFirstNm
Person LastLauttPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2023-05-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDavid FlicekPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11325 South Cliff AveAddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP571175045ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,499,957,286GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addressavera.org/locations/mckennan/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1911FormationYr
Legal Domicile StateSDLegalDomicileStateCd
Activity Or MissionPromotion of HealthActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee8980TotalEmployeeCnt
Total Volunteers1995TotalVolunteersCnt
Total Gross UBI$12,536,718TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$4,145,284NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$61,167,062PYContributionsGrantsAmt
CY Contributions Grants$41,698,551CYContributionsGrantsAmt
PY Program Service Revenue$1,220,053,336PYProgramServiceRevenueAmt
CY Program Service Revenue$1,279,316,288CYProgramServiceRevenueAmt
PY Investment Income$11,832,394PYInvestmentIncomeAmt
CY Investment Income$5,835,460CYInvestmentIncomeAmt
PY Other Revenue$78,006,490PYOtherRevenueAmt
CY Other Revenue$85,878,800CYOtherRevenueAmt
PY Total Revenue$1,371,059,282PYTotalRevenueAmt
CY Total Revenue$1,412,729,099CYTotalRevenueAmt
PY Grants And Similar Paid$1,968,871PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$724,460CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$642,862,668PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$700,913,378CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$243,629CYTotalFundraisingExpenseAmt
PY Other Expenses$634,014,859PYOtherExpensesAmt
CY Other Expenses$703,571,164CYOtherExpensesAmt
PY Total Expenses$1,278,846,398PYTotalExpensesAmt
CY Total Expenses$1,405,209,002CYTotalExpensesAmt
PY Revenues Less Expenses$92,212,884PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$7,520,097CYRevenuesLessExpensesAmt
Total Assets BOY$1,439,516,677TotalAssetsBOYAmt
Total Assets EOY$1,383,813,699TotalAssetsEOYAmt
Total Liabilities BOY$645,566,822TotalLiabilitiesBOYAmt
Total Liabilities EOY$620,515,284TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$793,949,855NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$763,298,415NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services and guided by Christian values.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,260,755,871ExpenseAmt
Grant$724,460GrantAmt
Revenue$1,353,905,939RevenueAmt
DescAvera McKennan's mission is to provide healthcare services to Sioux Falls, South Dakota residents and residents of the surrounding area. Avera McKennan is a 501(c)(3) organization affiliated with Avera Health. Avera McKennan consists of a 572-bed hospital, a 53-bed heart hospital and a 114-bed nursing home in Sioux Falls, SD. Major service lines include oncology, surgery, obstetrics, pediatrics, neonatology, emergency and trauma, critical care including EICU, radiology and diagnostic imaging, psychiatry, pulmonary, orthopedics, neurology, cardiology and gastroenterology. Transplant services include solid organ (kidney, liver, and pancreas) and bone marrow transplant.Program service statement continued on Schedule O.Avera McKennan owns or leases rural critical hospitals and a nursing home in South Dakota including a 25-bed critical access hospital and a 42-bed nursing home in Gregory, SD, a 25-bed critical access hospital in Milbank, SD, a 23-bed critical access hospital in Dell Rapids, SD, an 18-bed critical access hospital in Flandreau, SD, an 11-bed critical access hospital in Miller (Hand County), SD and an 11-bed critical access hospital in Rock Rapids, IA. Services offered by the rural critical access hospitals include radiology and imaging, colonoscopy and endoscopy, therapy and rehabilitation, 24-hour emergency care, chemotherapy, orthopedics, cardiovascular testing, surgery, dialysis and obstetrics.In addition, Avera McKennan provides clinical care, secondary and primary, through physician clinics in South Dakota, Northwest Iowa, Southwest Minnesota and Northeastern Nebraska. The physician clinics provide primary care and urgent care, and specialties such as cardiology, dermatology, endocrinology, gastroenterology, hematology, hepatology, infectious disease, internal medicine, neonatology, nephrology, neurology, ob/gyn, oncology, ophthalmology, pediatrics, orthopedics, pain management, psychiatry, pulmonology, general surgery, and vascular services. Following is a breakdown of these statistics by facility:Avera McKennan Hospital25,087 Acute patient discharges1,918 Newborn patient discharges427,544 Outpatient visits3,697 Newborn patient days1,097,966 Clinic visitsAvera Heart Hospital2,433 Acute patient discharges10,388 Outpatient visits64,512 Clinic visitsAvera Prince of Peace34,777 Long-term care resident days346 Long Term Care patient dischargesAvera Gregory Hospital (CAH)297 Acute patient discharges91 Swing bed patient discharges11,051 Outpatient visits784 Swing-bed patient days15,731 Clinic visitsAvera Rosebud Country Care Center10,067 Long-term care resident days27 Long Term Care patient dischargesAvera Milbank Hospital (CAH)285 Acute patient discharges41 Newborn patient discharges87 Swing bed patient discharges20,588 Outpatient visits59 Newborn patient days665 Swing-bed patient days28,762 Clinic visitsAvera Dell Rapids Hospital (CAH)119 Acute patient discharges50 Swing bed patient discharges9,999 Outpatient visits518 Swing-bed patient days14,098 Clinic visitsAvera Flandreau Hospital (CAH)173 Acute patient discharges16 Swing Bed patient discharges11,311 Outpatient visits166 Swing-bed patient days9,157 Clinic visitsAvera Hand County Hospital (CAH)194 Acute patient discharges48 Swing Bed patient discharges11,282 Outpatient visits343 Swing-bed patient days9,084 Clinic visitsAvera Merrill Pioneer Hospital (CAH) 113 Acute patient discharges28 Swing Bed patient discharges8,806 Outpatient visits280 Swing-bed patient days6,227 Clinic visitsAvera McKennan 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 $78,274,659.Avera McKennan also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera McKennan 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 McKennan engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed.Desc
Total Program Service Expenses$1,260,755,871TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document556IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee8980EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJamie SchaeferPersonNm
Phone6053223992PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
David Flicek
President42.000.00Yes (X)Yes (X)$0$1,291,126$45,202
Cristina Hill Jensen MD
Board Trustee/Gastroenterology42.000.00Yes (X)$850,539$0$46,914
Alisa Reindl MD
Board Trustee/Family Medicine42.000.00Yes (X)$239,738$0$23,051
Rick Kooima MD
Board Trustee/Chief of Staff42.000.00Yes (X)$297,775$0$47,414
Mary Dally
Chair2.000.00Yes (X)Yes (X)$0$0$0
Tom Biegler
Vice Chair2.000.00Yes (X)Yes (X)$0$0$0
Jennifer Bunkers-Board Trustee
Philanthropy Council Chair2.000.00Yes (X)Yes (X)$0$0$0
Sister Carmella Luke
Board Trustee2.000.00Yes (X)$0$0$0
Sister Joan Reichelt
Board Trustee2.000.00Yes (X)$0$0$0
Sister Mary Carole Curran
Board Trustee2.000.00Yes (X)$0$0$0
Sister Lucille Welbig
Board Trustee2.005.00Yes (X)$0$0$0
Jawad Nazir MD-Board Trustee
Infectious Disease & Internal Med42.000.00Yes (X)$660,586$0$48,164
Hugh Venrick
Board Trustee2.000.00Yes (X)$0$0$0
Van Fishback
Board Trustee2.000.00Yes (X)$0$0$0
J Pat Costello
Board Trustee2.000.00Yes (X)$0$0$0
Laurie Knutson
Board Trustee2.000.00Yes (X)$0$0$0
Alejandro Ramirez
Board Trustee2.000.00Yes (X)$0$0$0
Harriet Yocum
Board Trustee2.000.00Yes (X)$0$0$0
Jennifer Kirby
Board Trustee2.000.00Yes (X)$0$0$0
Randy Knecht
Board Trustee2.000.00Yes (X)$0$0$0
Jared Friedman MD
Board Trustee/Chief of Staff2.0040.00Yes (X)$0$515,368$54,730
Julie Lautt
CFO Avera Health; Sec/Treas0.1046.30Yes (X)$0$1,051,228$16,194
Michael Elliott - Sr Vice
President Medical Affairs/CMO40.000.00$539,629$0$45,755Yes (X)
Lori Popkes
Sr Vice President40.000.00$389,245$0$44,546Yes (X)
Curtis Hohman
Sr Vice President40.000.00$401,004$0$25,570Yes (X)
Sandra King
Director Operative Services40.000.00$198,581$0$20,578Yes (X)
Todd Zimprich MD
Neurology40.000.00$1,835,525$0$47,414Yes (X)
Brian Knutson MD
Dermatology40.000.00$1,301,746$0$45,414Yes (X)
Alex Linn MD
Neurology40.000.00$1,443,254$0$45,415Yes (X)
Travis Liddell MD
Surgery/Orthopedics40.000.00$1,357,556$0$51,691Yes (X)
Richard Conklin MD
Hematology/Oncology40.000.00$1,441,491$0$55,440Yes (X)
Steve Petersen - Former Key
Employee VP-Pharmacy0.0040.00$0$287,391$29,444Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,956,669TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,145,113TotReportableCompRltdOrgAmt
Total Other Compensation$692,936TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1131IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Health
3900 West Avera DriveSioux FallsSD57108Shared & eCare services$136,937,437
Journey Group Companies
4500 W 58th StSioux FallsSD57108Construction services$30,032,348
AMN Healthcare Inc
12400 High Bluff DrSan DiegoCA92130Contract labor$11,386,465
Surgical Institute of South Dakota PC
911 E 20th St 700Sioux FallsSD57105Medical Dir & Prof Fees$5,354,138
Sanford School of Medicine
1400 W 22nd StSioux FallsSD57105Physician services$4,312,164
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K70CntrctRcvdGreaterThan100KCnt
Federated Campaigns$43,324FederatedCampaignsAmt
Related Organizations$1,689,457RelatedOrganizationsAmt
Government Grants$27,351,472GovernmentGrantsAmt
All Other Contributions$12,614,298AllOtherContributionsAmt
Total Contributions$41,698,551TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient service revenue622110$1,154,581,212$1,154,581,212
Patient and clinic621500$93,677,384$89,999,535$3,677,849
Inc from subsidiaries423000$360,692$360,692

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,697,000TotalRevenueColumnAmt
Related Or Exempt Func Income$30,697,000RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,279,316,288TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$888,819TotalRevenueColumnAmt
Exclusion$888,819ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,591,779RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$3,839,348RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$1,247,569RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,247,569TotalRevenueColumnAmt
Exclusion-$1,247,569ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,614,906SecuritiesAmt
Other$331,735OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

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

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,614,906SecuritiesAmt
Other$331,735OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,946,641TotalRevenueColumnAmt
Exclusion$4,946,641ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$166,124,426GrossSalesOfInventoryAmt
Cost Of Goods Sold$83,388,839CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,735,587TotalRevenueColumnAmt
Related Or Exempt Func Income$78,162,538RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,573,049UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Commercial testing621500$2,283,744$2,283,744
Sports program900099$2,002,076$2,002,076
A/R Interest Income900099$104,962$104,962
FieldValueIRS element (for citing)
Other Revenue Total$4,390,782OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,412,729,099TotalRevenueColumnAmt
Related Or Exempt Func Income$1,353,905,939RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$12,536,718UnrelatedBusinessRevenueAmt
Exclusion$4,587,891ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$173,352TotalAmt
Program Services$173,352ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$551,108TotalAmt
Program Services$551,108ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,504,433TotalAmt
Program Services$2,839,370ProgramServicesAmt
Management And General$1,665,063ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$473,552TotalAmt
Program Services$473,552ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$568,561,127TotalAmt
Program Services$560,030,597ProgramServicesAmt
Management And General$8,530,530ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$27,013,371TotalAmt
Program Services$26,515,531ProgramServicesAmt
Management And General$497,840ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$63,516,289TotalAmt
Program Services$62,416,385ProgramServicesAmt
Management And General$1,099,904ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$36,844,606TotalAmt
Program Services$36,057,644ProgramServicesAmt
Management And General$786,962ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$340,726TotalAmt
Program Services$4,710ProgramServicesAmt
Management And General$336,016ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$49,283TotalAmt
Management And General$49,283ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$257,837,864TotalAmt
Program Services$148,807,455ProgramServicesAmt
Management And General$108,984,927ManagementAndGeneralAmt
Fundraising$45,482FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,169,456TotalAmt
Program Services$743,229ProgramServicesAmt
Management And General$284,902ManagementAndGeneralAmt
Fundraising$141,325FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,467,068TotalAmt
Program Services$13,449,357ProgramServicesAmt
Management And General$2,008,616ManagementAndGeneralAmt
Fundraising$9,095FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,877,418TotalAmt
Program Services$6,600,221ProgramServicesAmt
Management And General$1,252,365ManagementAndGeneralAmt
Fundraising$24,832FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$24,580,362TotalAmt
Program Services$18,811,427ProgramServicesAmt
Management And General$5,761,195ManagementAndGeneralAmt
Fundraising$7,740FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,045,845TotalAmt
Program Services$3,922,825ProgramServicesAmt
Management And General$123,020ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,042,146TotalAmt
Program Services$2,966,196ProgramServicesAmt
Management And General$75,950ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$14,343,324TotalAmt
Program Services$11,765,991ProgramServicesAmt
Management And General$2,577,333ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$51,529,681TotalAmt
Program Services$45,923,205ProgramServicesAmt
Management And General$5,605,927ManagementAndGeneralAmt
Fundraising$549FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,539,223TotalAmt
Program Services$3,418,064ProgramServicesAmt
Management And General$3,121,159ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical supplies$279,459,788$278,407,011$1,038,408$14,369
Repairs and maintenance$23,171,850$22,761,748$410,102
Research$2,780,973$2,780,973
UBI tax$997,820$997,820

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,338,337TotalAmt
Program Services$10,338,100ProgramServicesAmt
Fundraising$237FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,405,209,002TotalAmt
Program Services$1,260,755,871ProgramServicesAmt
Management And General$144,209,502ManagementAndGeneralAmt
Fundraising$243,629FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$64,283,720BOYAmt
EOY$21,314,824EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,127,502BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$166,789,819BOYAmt
EOY$195,753,862EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$44,363,461BOYAmt
EOY$34,209,513EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,764,427BOYAmt
EOY$7,925,277EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,165,928,143LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$574,861,197LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$565,837,102BOYAmt
EOY$591,066,946EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$35,860,483BOYAmt
EOY$42,829,413EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$384,512,480BOYAmt
EOY$321,138,318EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$14,406,808BOYAmt
EOY$16,074,703EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$38,085,871BOYAmt
EOY$38,076,281EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$113,485,004BOYAmt
EOY$115,424,562EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,439,516,677BOYAmt
EOY$1,383,813,699EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$105,991,971BOYAmt
EOY$113,510,876EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$14,277,434BOYAmt
EOY$895,292EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$398,831,895BOYAmt
EOY$393,513,883EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$73,086,703BOYAmt
EOY$78,034,916EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,378,819BOYAmt
EOY$34,560,317EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$645,566,822BOYAmt
EOY$620,515,284EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$768,340,216BOYAmt
EOY$742,764,230EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,609,639BOYAmt
EOY$20,534,185EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$793,949,855BOYAmt
EOY$763,298,415EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,439,516,677BOYAmt
EOY$1,383,813,699EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$7,520,097ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$34,201,011NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$3,970,526OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$49,283OtherActivitiesAmt
Total Lobbying Expenditures$49,283TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAvera McKennan participates through various hospital organizations to promote legislation that would result in strengthening health care delivery systems on a national, regional, and local level. Dues were paid to the following organizations and a portion is attributable to lobbying. South Dakota Association of Healthcare Organizations $33,715 Sioux Falls Chamber of Commerce 14,245 National Rural Health Association 61 Iowa Hospital Association 1,262ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcYes (1)AgentTrusteeEtcInd
Beginning Balance$19,524BeginningBalanceAmt
Additions During Year$58,598AdditionsDuringYearAmt
Distributions During Year$64,252DistributionsDuringYearAmt
Ending Balance$13,870EndingBalanceAmt
Incl Escrow Custodial Acct Liab0InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,588,451BeginningYearBalanceAmt
Investment Earnings Or Losses$895,615InvestmentEarningsOrLossesAmt
End Year Balance$6,484,066EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,469,827BeginningYearBalanceAmt
Investment Earnings Or Losses$118,624InvestmentEarningsOrLossesAmt
End Year Balance$5,588,451EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,797,240BeginningYearBalanceAmt
Investment Earnings Or Losses$672,587InvestmentEarningsOrLossesAmt
End Year Balance$5,469,827EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,256,565BeginningYearBalanceAmt
Investment Earnings Or Losses$540,675InvestmentEarningsOrLossesAmt
End Year Balance$4,797,240EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,764,520BeginningYearBalanceAmt
Investment Earnings Or Losses$492,045InvestmentEarningsOrLossesAmt
End Year Balance$4,256,565EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$29,608,656InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$28,209,754OtherCostOrOtherBasisAmt
Book Value$57,818,410BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$4,327,649InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$677,509,722OtherCostOrOtherBasisAmt
Depreciation$296,787,565DepreciationAmt
Book Value$385,049,806BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,423,096OtherCostOrOtherBasisAmt
Depreciation$10,799,263DepreciationAmt
Book Value$1,623,833BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$361,002,890OtherCostOrOtherBasisAmt
Depreciation$260,163,278DepreciationAmt
Book Value$100,839,612BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$52,846,376OtherCostOrOtherBasisAmt
Depreciation$7,111,091DepreciationAmt
Book Value$45,735,285BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$591,066,946TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Avera Pooled Investments$273,768,683F
Interest in Avera Health Foundation$21,516,785F
Investment in Heart Hospital of South Dakota, LLC$22,128,190F
Investments in affiliated companies$2,821,057F
Investment in Alucent$903,603F
FieldValueIRS element (for citing)
Total Book Value Securities$321,138,318TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Other Assets$5,126,614
Other Receivables$38,855,972
Due from Related party$11,158,406
Right of use assets$60,283,570
FieldValueIRS element (for citing)
Total Book Value Other Assets$115,424,562TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Other Liabilities$19,434,195
Market value of interest swap$3,495,832
Estimated third-party payor settlements$7,607,892
Minority interest$4,022,398
FieldValueIRS element (for citing)
Total Liability$34,560,317TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 1b:The Organization holds funds in trust on behalf of its long-term care residents. Many small dollar transactions flow in and out of this account. The account is managed by the nursing home staff. The state has strict guidelines on how these accounts are managed.
Part V, Line 4:The Organization's endowment consists of a portion of their interest in the net assets of 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. The Organization currently does not have any board designated endowment funds.
Part X, Line 2:Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,268,248TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,268,248NetCommunityBenefitExpnsAmt
Total Expense0.01370TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$103,170,029TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,886,072DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,283,957NetCommunityBenefitExpnsAmt
Total Expense0.01800TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,559,461TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,545,059DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,014,402NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$124,997,738TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$79,431,131DirectOffsettingRevenueAmt
Net Community Benefit Expns$45,566,607NetCommunityBenefitExpnsAmt
Total Expense0.03240TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,802,797TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$504,099DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,298,698NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,484,514TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,756,490DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,728,024NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,121,494TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$49,258,958DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,862,536NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,916,254TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,015,510DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,900,744NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,371,005TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,371,005NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$90,696,064TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,535,057DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,161,007NetCommunityBenefitExpnsAmt
Total Expense0.02220TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$215,693,802TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$138,966,188DirectOffsettingRevenueAmt
Net Community Benefit Expns$76,727,614NetCommunityBenefitExpnsAmt
Total Expense0.05460TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$75,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$75,000NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$281,502TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$281,502NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,500NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,069TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,069NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,682TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,682NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$392,753TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$392,753NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$36,239,541BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$286,824,425ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$311,914,736CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$25,090,311MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities8HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (8 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndChildrens HospitalChildrensHospitalIndTeaching HospitalTeachingHospitalIndResearch FacilityResearchFacilityIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDescCritical Access HospitalCriticalAccessHospitalInd
Avera McKennan
11325 S Cliff AveSioux FallsSD57117See Part V Section C10563Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)40 Provider Based Clinics
Heart Hospital of South Dakota LLC
24500 W 69th StreetSioux FallsSD57108See Part V Section C41953Yes (X)Yes (X)Yes (X)2/3 Owner in Joint Venture
Avera Milbank Area Hospital
3901 Virgil AveMilbankSD57252See Part V Section C48451Yes (X)Yes (X)Yes (X)2 Provider Based Clinics & 2 Rural Health PB ClinicsYes (X)
Avera Gregory Healthcare Center
4400 Park AveGregorySD57533See Part V Section C54875Yes (X)Yes (X)Yes (X)2 Provider Based Clinics & 2 Rural Health PB ClinicsYes (X)
Avera Dells Area Health Center
5909 N Iowa AvenueDell RapidsSD57022See Part V Section C50754Yes (X)Yes (X)Yes (X)3 Provider Based ClinicsYes (X)
Avera Flandreau Medical Center
6214 N PrairieFlandreauSD57028See Part V Section C10540Yes (X)Yes (X)Yes (X)1 Rural Health Provider Based ClinicYes (X)
Avera Hand County Memorial Hospital
7300 W 5th StMillerSD57362See Part V Section C53862Yes (X)Yes (X)Yes (X)1 Provider Based ClinicYes (X)
Avera Merrill Pioneer Hospital
81100 S 10th AveRock RapidsIA51246See Part V Section C600118HYes (X)Yes (X)Yes (X)2 Rural Health Provider Based ClinicsYes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (8 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndPrior CHNA ImpactPriorCHNAImpactIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndProvided Written NoticeProvidedWrittenNoticeIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndOther Actions TakenOtherActionsTakenIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndLook Back Medicare PrivateLookBackMedicarePrivateIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
Avera McKennan
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)Yes (1)Yes (1)Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Heart Hospital of South Dakota LLC
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)Yes (1)Yes (1)Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Gregory Healthcare Center
400Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Milbank Area Hospital
300Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Dells Area Health Center
500Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Flandreau Medical Center
600Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Hand County Memorial Hospital
700Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Avera Merrill Pioneer Hospital
800Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)21Yes (1)00Yes (1)Yes (X)See Part V, Section CYes (X)Yes (1)21Yes (1)See Part V, Section C0Yes (1)Yes (X)250.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)See Part V, Section CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (57 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Avera McKennanPart V, Section B, Line 5: Avera McKennan solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted in April 2021. Key informant individual interviews were conducted in May 2021. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve these populations through their activities.
Heart Hospital of South Dakota, LLCPart V, Section B, Line 5: Heart Hospital of South Dakota, LLC solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted in April 2021. Key informant individual interviews were conducted in May 2021. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve these populations through their activities.
Avera Gregory Healthcare CenterPart V, Section B, Line 5: This year the Avera Gregory Hospital completed our 2021 Community Health Needs Assessment. We used an outside consultation to bring together multiple community members and organizations to answer the question: "What health needs can our facility be a partner in addressing?" Our organization used primary evidence gathering techniques with one-on-one interviews, online surveys, and town hall events. We also met with local organizations including the lions club, rotary club, city council, county commissioners, the local EMS providers, the volunteer fire department, and various church organization that represented at risk community members. The Avera Gregory Hospital Advisory Board approved the Community Health Needs Assessment.
Avera Milbank Area HospitalPart V, Section B, Line 5: The assessment process, initiated by Milbank Area Hospital Avera, is an effort to identify significant unmet health needs in the community. Community input was solicited through surveys and personal interviews with community members with special knowledge of the needs of the community. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations.
Avera Dells Area Health CenterPart V, Section B, Line 5: Community input was solicited using a variety of methods. To gather a broad range of interests and ensure accurate community input and representation, individual personalized invitations went out to various groups and individuals. In addition, medically underserved, low income, and minority population groups were also invited. In addition, there were two weeks of community surveys conducted in July 2021.
Avera Flandreau Medical CenterPart V, Section B, Line 5: Community input was solicited using a variety of methods. The Avera Flandreau Hospital identified individuals, and the Avera Flandreau Hospital Advisory Board was instrumental in generating community member involvement. Personalized invitations were extended to engage individuals in the CHNA process. Involved individuals and organizations include: Food Pantry, Public Health, Senior Meals Program, the Ministerial Association, the Avera Medical Group Flandreau Medical Staff, Avera Medical Group Flandreau Clinic Manager, Avera Flandreau Hospital Administrator, and the Avera Flandreau Hospital Director of Nursing and focus groups and paper surveys from May 23, 2022 to June 13, 2022.
Avera Hand County Memorial HospitalPart V, Section B, Line 5: The CHNA process began by defining the community and collecting secondary data and resources. Once that was completed, the process continued with primary data collection including online and paper surveys. The internal CHNA committee reviewed the data collected and identified the community health needs to improve overall health of the community. The needs were then prioritized. The Avera Hand County Memorial Hospital Board of Directors approved the Community Health Needs Assessment.
Avera Merrill Pioneer HospitalPart V, Section B, Line 5: Avera Merrill Pioneer Hospital conducted a community survey to collect a broad view of the community. The survey was implemented through an online format to residents in Lyon County. The survey was promoted on Facebook, with the goal of reaching a wide demographic representative of the overall county population. Paper copies of the survey were also dispersed at the Avera Medical Group Clinics in Rock Rapids, George, and Larchwood. Key informant interviews were conducted to get a closer look at problem areas identified from a previous community health needs assessment and to connect with individuals serving vulnerable/medically underserved populations. The key informant interviews were conducted over the phone with Lyon County Public Health, Sioux Rivers Regional Disability Services Coordinator, Lyon County Ambulance Director, Rock Rapids Health Center Director of Nursing, and the Central Lyon and West Lyon High School Superintendents. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations.
Avera McKennanPart V, Section B, Line 6a: The CHNA was conducted with Heart Hospital of South Dakota, LLC, Sioux Falls VA Medical Center, and Sanford USD Medical Center.
Heart Hospital of South Dakota, LLCPart V, Section B, Line 6a: The CHNA was conducted with Avera McKennan, Sioux Falls VA Medical Center, and Sanford USD Medical Center.
Avera McKennanPart V, Section B, Line 6b: City of Sioux Falls Health Department
Heart Hospital of South Dakota, LLCPart V, Section B, Line 6b: City of Sioux Falls Health Department
Avera McKennanPart V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. The community health priority areas identified were: Active Living, Healthy Eating, Mental Health and Substance Use, Oral Health and Preventative Care. The identified needs will be addressed through a three-year, collaborative Community Health Improvement Plan (CHIP). The CHIP is a multi-partner collaboration spearheaded by the Sioux Falls Health Department, Avera McKennan Hospital & University Health Center (including Avera Heart Hospital), Sanford USD Medical Center and the Sioux Falls VA Health Care System. Lead agencies were identified to lead the three work groups established to address the five priority areas. Avera McKennan is co-leading efforts, in partnership with Sanford Health, to address Mental Health and Substance Abuse and Preventative Care strategies. In addition, Avera McKennan and the Avera Heart Hospital will participate in efforts to support strategies to improve Active Living, Healthy Eating and Oral Health. The following actions will be taken in future years to address the identified and prioritized community health needs:PRIORITY AREA #1: ACTIVE LIVINGGOAL: Get People Moving MoreOBJECTIVE 1: Decrease percentage of adults who do not participate in any leisure time activity by 2024.STRATEGIES Create a comprehensive community directory of resources and programs and distribute it across multiple channels to ensure it is accessible to residents of all ages. Track and promote active lifestyle programming activities in the community on an ongoing basis. Implement a "Physical Activity Screening and Tailored Prescription" program in clinical settings. Promote use of the Sioux Falls recreation trail system for exercise and transportation. Explore the underlying drivers of the high rate of fall deaths in Minnehaha County and promote evidence-based Falls Prevention programs in the community.OBJECTIVE 2: Add complete streets elements to the Sioux Falls network of streets and sidewalks by 2024.STRATEGIES Advocate for creation of an Active Transportation Advisory Board. Conduct an evaluation of the implementation of the City of Sioux Falls Complete Streets Policy. Promote safety for biking and walking in residential areas and on the recreation trail. Utilize the City of Sioux Falls Health in All Policies Committee to identify and promote collaboration across city master plans (e.g. Bicycle Plan, Pedestrian Plan, and Sustainability and Climate Action Plan) to improve active transportation infrastructure in the built environment.PRIORITY AREA #2: HEALTHY EATING GOAL: Increase Consumption of Healthy FoodsOBJECTIVE 1: Establish two new sites where residents can access fresh produce in low-income low access census tracts by 2024.STRATEGIES Promote establishment of community gardens and/or farmer's markets in Food Access Priority census tracts. Incentivize the private and non-profit sectors to establish new grocery stores or innovative programs to increase residents' access to health foods in Food Access Priority census tracts. Establish an active local food coalition by aligning key players such as the Food Council and the urban agriculture task force. OBJECTIVE 2: Increase the number of worksites with evidence-based healthy food and beverage policies by 2024.STRATEGIES Promote healthy eating in the workplace and advocate for healthy nutrition policies at worksites. Partner with organizations to establish baseline measures through a workplace survey. Re-launch Healthy Place program for restaurants and expand to include recognition for worksites.PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE USEGOAL: Reduce Deaths Due to Intentional and Unintentional InjuriesOBJECTIVE 1: Reduce the rate of suicide in Minnehaha County by 2024.STRATEGIES Create a city-wide campaign to normalize mental health conversations and care using evidence-based methodologies (e.g. "I go to therapy"). Promote 988 phone number (starting in July 2022) as access point for behavioral health and crisis support along with the Helpline Center mental health resource database to increase awareness of health and social service resources. Provide mental health first aid trainings in worksites, schools and organizations across the community to broaden early intervention impact. Promote Lethal Means Safety trainings in the community to reduce individuals' access to lethal means such as medications and firearms.OBJECTIVE 2: Decrease the percentage of driving deaths with alcohol involvement in Minnehaha County by 2024. STRATEGIES Media campaign against alcohol overuse and driving while under the influence. Responsible server training for bars and restaurants. School-based education/programs for teens and college campuses on alcohol abuse.OBJECTIVE 3: Decrease the drug poisoning death rate in Minnehaha County by 2024. STRATEGIES Implement community campaigns targeting opioid and other drug use, highlighting harmful substances & safe storage of medications at home. Expand youth mentoring programs. Promote drug take back events, neutralizing packets, and daily pharmacy drops. Improve access to Medication-assisted treatment (MAT) and Naloxone.PRIORITY AREA #4: ORAL HEALTHGOAL: Improve Oral Health Through The Reduction Of Dental DiseasesOBJECTIVE 1: Increase the proportion of individuals utilizing the oral health system by 2024. STRATEGIES Develop an education and awareness campaign to increase the number of individuals in priority populations who have a dental visit, including 1-2 year olds, pregnant women, Medicaid recipients, and aging populations. Develop an advocacy plan to address access to care issues including Medicaid expansion and Medicaid reimbursement. Partner with local dental clinics to host free clinic events. Promote oral health assessments and referral to a dental home at medical appointments. Assist in re-implementation of the 3rd grade survey in the MSA and other related data collection. Simplify consent process to enable provision of dental care services to more children at elementary schools. PRIORITY AREA #5: Preventive CareGOAL: Increase Utilization of Preventative CareOBJECTIVE 1: Increase the percentage of residents who have had a preventative care visit in the last year by 2024. STRATEGIES Explore a system for data-sharing among local health systems to get baseline data on number of residents who had a preventative care visit. Utilize Community Health Workers to share information about primary care, cancer screenings, immunizations, and mental health resources in the community and to help individuals get connected to a provider. Educate policy and decision makers on the resident need and economic benefits of Medicaid expansion that can help people access primary care. Utilize education and engagement resources for providers to communicate with patients about screenings (e.g. information about All Women Count, etc.). Encourage worksites and employees to access screenings through primary care providers and provide on-site immunization clinics. Increase options to access transportation at no cost to individuals without transportation to attend appointments. Develop resources for use at The Link to connect clients with preventive care services.Avera McKennan and Avera Heart Hospital are addressing, or collaborating to address, all aspects of all top needs identified in the 2022 Community Health Needs Assessment.Statement continued to Part V, Section C.
Heart Hospital of South Dakota, LLCPart V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. The community health priority areas identified were: Active Living, Healthy Eating, Mental Health and Substance Use, Oral Health and Preventative Care. The identified needs will be addressed through a three-year, collaborative Community Health Improvement Plan (CHIP). The CHIP is a multi-partner collaboration spearheaded by the Sioux Falls Health Department, Avera McKennan Hospital & University Health Center (including Avera Heart Hospital), Sanford USD Medical Center and the Sioux Falls VA Health Care System. Lead agencies were identified to lead the three work groups established to address the five priority areas. Avera McKennan is co-leading efforts, in partnership with Sanford Health, to address Mental Health and Substance Abuse and Preventative Care strategies. In addition, Avera McKennan and the Avera Heart Hospital will participate in efforts to support strategies to improve Active Living, Healthy Eating and Oral Health. The following actions will be taken in future years to address the identified and prioritized community health needs:PRIORITY AREA #1: ACTIVE LIVINGGOAL: Get People Moving MoreOBJECTIVE 1: Decrease percentage of adults who do not participate in any leisure time activity by 2024.STRATEGIES Create a comprehensive community directory of resources and programs and distribute it across multiple channels to ensure it is accessible to residents of all ages. Track and promote active lifestyle programming activities in the community on an ongoing basis. Implement a "Physical Activity Screening and Tailored Prescription" program in clinical settings. Promote use of the Sioux Falls recreation trail system for exercise and transportation. Explore the underlying drivers of the high rate of fall deaths in Minnehaha County and promote evidence-based Falls Prevention programs in the community.OBJECTIVE 2: Add complete streets elements to the Sioux Falls network of streets and sidewalks by 2024.STRATEGIES Advocate for creation of an Active Transportation Advisory Board. Conduct an evaluation of the implementation of the City of Sioux Falls Complete Streets Policy. Promote safety for biking and walking in residential areas and on the recreation trail. Utilize the City of Sioux Falls Health in All Policies Committee to identify and promote collaboration across city master plans (e.g. Bicycle Plan, Pedestrian Plan, and Sustainability and Climate Action Plan) to improve active transportation infrastructure in the built environment.PRIORITY AREA #2: HEALTHY EATING GOAL: Increase Consumption of Healthy FoodsOBJECTIVE 1: Establish two new sites where residents can access fresh produce in low-income low access census tracts by 2024.STRATEGIES Promote establishment of community gardens and/or farmer's markets in Food Access Priority census tracts. Incentivize the private and non-profit sectors to establish new grocery stores or innovative programs to increase residents' access to health foods in Food Access Priority census tracts. Establish an active local food coalition by aligning key players such as the Food Council and the urban agriculture task force. OBJECTIVE 2: Increase the number of worksites with evidence-based healthy food and beverage policies by 2024.STRATEGIES Promote healthy eating in the workplace and advocate for healthy nutrition policies at worksites. Partner with organizations to establish baseline measures through a workplace survey. Re-launch Healthy Place program for restaurants and expand to include recognition for worksites.PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE USEGOAL: Reduce Deaths Due to Intentional and Unintentional InjuriesOBJECTIVE 1: Reduce the rate of suicide in Minnehaha County by 2024.STRATEGIES Create a city-wide campaign to normalize mental health conversations and care using evidence-based methodologies (e.g. "I go to therapy"). Promote 988 phone number (starting in July 2022) as access point for behavioral health and crisis support along with the Helpline Center mental health resource database to increase awareness of health and social service resources. Provide mental health first aid trainings in worksites, schools and organizations across the community to broaden early intervention impact. Promote Lethal Means Safety trainings in the community to reduce individuals' access to lethal means such as medications and firearms.OBJECTIVE 2: Decrease the percentage of driving deaths with alcohol involvement in Minnehaha County by 2024. STRATEGIES Media campaign against alcohol overuse and driving while under the influence. Responsible server training for bars and restaurants. School-based education/programs for teens and college campuses on alcohol abuse.OBJECTIVE 3: Decrease the drug poisoning death rate in Minnehaha County by 2024. STRATEGIES Implement community campaigns targeting opioid and other drug use, highlighting harmful substances & safe storage of medications at home. Expand youth mentoring programs. Promote drug take back events, neutralizing packets, and daily pharmacy drops. Improve access to Medication-assisted treatment (MAT) and Naloxone.PRIORITY AREA #4: ORAL HEALTHGOAL: Improve Oral Health Through The Reduction Of Dental DiseasesOBJECTIVE 1: Increase the proportion of individuals utilizing the oral health system by 2024. STRATEGIES Develop an education and awareness campaign to increase the number of individuals in priority populations who have a dental visit, including 1-2 year olds, pregnant women, Medicaid recipients, and aging populations. Develop an advocacy plan to address access to care issues including Medicaid expansion and Medicaid reimbursement. Partner with local dental clinics to host free clinic events. Promote oral health assessments and referral to a dental home at medical appointments. Assist in re-implementation of the 3rd grade survey in the MSA and other related data collection. Simplify consent process to enable provision of dental care services to more children at elementary schools. PRIORITY AREA #5: Preventive CareGOAL: Increase Utilization of Preventative CareOBJECTIVE 1: Increase the percentage of residents who have had a preventative care visit in the last year by 2024. STRATEGIES Explore a system for data-sharing among local health systems to get baseline data on number of residents who had a preventative care visit. Utilize Community Health Workers to share information about primary care, cancer screenings, immunizations, and mental health resources in the community and to help individuals get connected to a provider. Educate policy and decision makers on the resident need and economic benefits of Medicaid expansion that can help people access primary care. Utilize education and engagement resources for providers to communicate with patients about screenings (e.g. information about All Women Count, etc.). Encourage worksites and employees to access screenings through primary care providers and provide on-site immunization clinics. Increase options to access transportation at no cost to individuals without transportation to attend appointments. Develop resources for use at The Link to connect clients with preventive care services.Avera McKennan and Avera Heart Hospital are addressing, or collaborating to address, all aspects of all top needs identified in the 2022 Community Health Needs Assessment.Statement continued to Part V, Section C.
Avera Gregory Healthcare CenterPart V, Section B, Line 11: The community health needs assessment was completed during tax year 2021. Three needs were identified in the CHNA: need for new facilities in our area to administer healthcare, increase diagnostic capabilities of our imaging department to eliminate unnecessary travel, and increased need for dialysis in our community. The following actions will be taken in future years to address the identified and prioritized community health needs:Construction of new facilities: hospital, clinic, long term care center Conduct community assessment to determine needs in the new healthcare structures. Fundraising efforts in the community to raise money and awareness for the project. Complete construction of the new facility by 2024.Long travel for MRI services Data analysis on number of MRI screenings conducted in our area per month. Work with providers and Emergency medical personnel to determine which diagnostic device would be best for the area. Develop and implement construction plans for a MRI suite at our new proposed construction location.Lack of dialysis services in the area Data analysis on the medical need of dialysis in our service area vs availability of those services. Work with our nephrology team and local dialysis experts to determine the number of units required and staffing Integrate a new dialysis unit into the local construction project.Other topics that came forward through the assessment processes but were not found evident or impactful enough to focus on: COVID-19 concerns including noncompliance by community and vaccination and booster rates. Housing options that are available for new people moving to the community, safe and affordable, and assistive to the aging population. Workforce concerns in how we will continue to keep the healthcare campus, local EMS service, and home health and hospice services adequately staffed, including recruitment of a doctor of medicine (MD) and registered nurses to the community. Healthy eating options including access to fresh produce at the local grocery store, more restaurants with healthy food options, nutrition classes, and healthy snack options for staff on the healthcare campus.The community health needs assessment completed during tax year 2018 identified two needs: public awareness of hospital/clinic services and nutrition education. The following were addressed during fiscal year 2022.Public awareness of hospital/ clinic services:One identified weakness was our social media presence in our community. Our posting and engagement pattern was usually one or two wellness posts per quarter. Sometimes more frequently when we had to announce a clinic closure due to weather. With the onset of the COVID-19 pandemic our posting rate increased to almost weekly for over a year. We sent out information based on CDC recommendations, new PPE requirements for visitation in both the hospital and long term care center, and vaccine information. In addition to this we utilized other more traditional forms of media to include the local newspaper and radio advertisement. In 2021 we used all of these communication channels to update the community on the building status of the new facility as well as when we expect the project to be complete.Nutrition education: Initially in the three year CHNA period this was a huge focus for us as heart disease continues to be the number one cause of death in our service area year after year. We increased the hours of our contracted dietician and offered more counseling sessions with her for the community. We also used our coordinated care team to identify low income vulnerable patients that were most at risk for heart disease and provided one-on-one care to educate and assist with their nutritional needs. Assistance was provided to the local schools to assist teachers with nutritional education and teaching children at a young age the importance of a healthy diet combined with exercise.
Avera Milbank Area HospitalPart V, Section B, Line 11: Milbank Area Hospital Avera conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Milbank Area Hospital Avera leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Milbank Area Hospital Avera is committed to addressing the following identified significant community health need: Addition of mental health services. Greater outreach to ethnic minority patients. Health education and health screenings.The following actions will be taken in future years to address the identified and prioritized community health needs:Addition of mental health services Focus on adding mental health professionals to provide mental health services in the community. Educate and promote the 211 suicide prevention hot line. Collaborate with local school and community to provide education to school-age children about mental health in a relatable way. Continue grief support group in the community. Mental health screenings of patients at clinic and hospital registration.Greater outreach to ethnic minority patients Develop and strengthen relationships and partnerships with organizations currently serving ethnic minority populations. Distribute information packages to local corporation that employs large number of individuals with Hispanic background. Enhance offering and activities inclusive of all local cultural groups. When recruiting for various positions in the hospital and clinic, include the need for bilingual employees. Develop a community health worker program - focus on health disparities and advance health equities within underserved populations.Health education and health screenings Expand community health education and screenings, including lung and heart screening. Continue to provide bi-monthly radio interviews to educate on services available and promote health screenings such as mammograms and colon cancer screening.Milbank Area Hospital Avera will not be directly addressing other areas of concern identified through the assessment process. While the leadership team recognizes that other concerns exist, the hospital does not have the resources to address at this time.Milbank Area Hospital Avera continued to address the community health needs identified in the community health needs assessment completed in 2018. The following includes actions taken toward the previous report.FY2022 Update: Three primary care physicians have been recruited. A hospitalist program was formed which has improved workloads amongst medical staff, improving job satisfaction and patient care. There in an ongoing relationship with the local high school to offer curriculum and encourage heath careers. Students connect with all departments in the hospital during the class. FY2022 Update: Continued partnership with National Alliance on Mental Illness (NAMI) and a local group referred to as "Moving to Wellness" to offer and support classes and educational materials on mindfulness, grief, depression and anxiety. Resources have been provided to educate on ending the stigma of mental illness. FY2022 Update: Successful efforts have been made to improve communication with non-English speaking patients. Access to phone translation service has been implemented throughout the hospital campus. Focus has been placed on translation of appropriate patient materials. Effort and steps are being taken to add another translator.
Avera Dells Area Health CenterPart V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. Two needs were identified in the CHNA: Offer additional local healthcare services, and access/convenience to medical care.The following actions will be taken in future years to address the identified and prioritized community health needs:Avera Dells Area Hospital will seek to expand the list of services offered by seeking out new internal and external partnerships. The focus will be on services identified in the survey portion of the CHNA prioritization including therapy services, wound care, diabetes, specialty, and imaging procedures. The hospital is committed to investing resources to promote these services to the community once implemented. To track progress of this goal, Avera Dells Area Hospital will closely monitor usage of these services to verify the strategy is effective. Results will be shared with the leadership team at Avera Dell Rapids as well as the advisory board. Avera Dells Area Hospital will seek to expand access to care and make medical care more convenient in several ways. Many of the services offered are only offered once or twice per month. To provide patients with more convenient access to care, Avera Dells Area Hospital will focus on expanding access through additional days and times for both the current services and any additional services that are implemented as part of this CHNA. To track the progress of this goal, patient volumes will be assessed during expanded hours to ensure added value to patients. Results will be shared with the leadership team at Avera Dell Area Hospital as well as the advisory board. Avera Dells Area Hospital identified the following needs not being addressed in the 2022 Implementation Strategy: tobacco education/cessation, mental health, physical activity, outreach services, and nutrition education. Each of these needs were presented to the Avera Dells Area Medical Staff, Advisory Board, and Hospital Leadership Teams during the prioritization process, all of which felt there were other more impactful areas to focus on.Avera Dells Area Hospital continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.Improve public awareness of local health care service options, which will improve community engagement around health and wellness. Awareness can be improved and generated through the new Avera Dells Area Hospital webpage, as well as through other social media avenues and public events.FY2022 Update: Continued to use social media and online portals to promote local health care services available in the community. Participated in community events to promote local health services and educate the public on preventative health and wellness programs and opportunities. Continue to promote free dietary consultations to all community members living in the Avera Dells Area Hospital service area.FY2022 Update: Continued to use community events to promote healthy eating and education on the benefits of good nutrition on health.
Avera Flandreau Medical CenterPart V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. Two needs were identified in the CHNA: access to healthcare through affordability and chemical dependency. The following actions will be taken in future years to address the identified and prioritized community health needs:Access to Healthcare through Affordability- Avera is compliant with the Health Care Price Transparency Act and provides its pricing information to the public via its website. Avera has recently begun to provide out-of-pocket cost estimates for scheduled patients who will be paying for services with their own resources (not using a third-party payer). This process provides patients an estimate of what they will be responsible for after their visit. Avera is also nearing completion of a more automated process for all patients in which they will have an estimate of out-of-pocket costs they will incur for scheduled visits to Avera Flandreau Hospital and Avera Medical Group-Flandreau. - Avera offers charity care to those eligible for the service and for those who complete the necessary paperwork. Opportunities may exist to create greater awareness and greater ease of use of this process.- Avera Flandreau Hospital is actively participating in an effort to gain approval for Medicaid expansion along with Avera Health, and other hospitals in South Dakota. The facility is working to put the proposed legislation on a ballot measure and brought before the voters of South Dakota. An estimated 43,000 South Dakotans would be eligible for this expanded health insurance. Additional coverage would improve access to care and improve health outcomes for Moody County residents. Chemical Dependency Services- In 2020 Avera built the Avera Addiction Care Center in Sioux Falls. It is a residential addiction treatment facility, which offers programming and residential life for adults 18 and older. It is hoped that the expansion of services will create greater access to chemical dependency services.- Avera Behavioral Health Urgent Care is another possible resource to address chemical dependency situations in a timely manner. - The Avera Behavioral Health Assessment Team is available to our patients 24/7; this is a free service to the public. - Moody County Cares mental health board is community based and run by county residents. Avera Flandreau employees are active on the mental health board and will look for ways to partner toward meeting our goal. - The opportunity exists to partner with Flandreau area law enforcement such as the Flandreau Police Department, Moody County Sheriff, and the Santee Sioux Tribal Police. Avera Flandreau Hospital identified the following needs not being addressed in the 2021 Implementation Strategy: mental health, outreach services, and nutrition education. Each of these needs were presented to the Avera Flandreau Medical Staff, Advisory Board, and Hospital Leadership Team during the prioritization process, all which felt there were more impactful areas to focus on and utilize resources.Avera Flandreau continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.Mental Health and Chemical DependencyFY2022 Update: Avera Flandreau continued to improve public awareness of health care service options for individuals dealing with mental health concerns or chemical dependency. In January 2022, Avera Flandreau provided space in the clinic for a community mental health counselor and routinely makes referrals to this professional. Avera Flandreau Hospital provides financial support for the Hope Squad for education on suicide prevention through the Flandreau High School. The hope-squad program is an educational-school based, peer to peer curriculum. Their goals are preventing suicide though public awareness and education, reducing the stigma, and serving as a resource to those touched by suicide. Also in January 2022, Avera Flandreau co-sponsored an event at the high school that brought in a speaker from Emily's Hope to share the personal experience of the difficulties of dealing with a family member's drug overdose and how the drug use affected the whole family. The talk was followed by a question and answer session from the students.
Avera Hand County Memorial HospitalPart V, Section B, Line 11: Avera Hand County conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Hand County leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Hand County is committed to addressing the following prioritized community health needs: Mental Health Access and Resources. Health & Weight Management and Maintenance.The following actions will be taken in future years to address the identified and prioritized community health needs:Mental Health Access and Resources Work with the 211 center to review and update resource availability for the Hand County area. Evaluate contracting a Psychologist or Psychiatrist to aid in mental health care. Evaluate expansion ideas within the current resources to assist with mental health needs of the community. Evaluate the feasibility of expanding local mental health provider services. If deemed feasible, the hospital will commit financial resources and staff time for development, implementation, and sustainability. Increasing outpatient mental health care availability may decrease emergency visits due to mental health diagnoses.Health & Weight Management and Maintenance Use the hospital and clinic's Facebook platform to offer health, fitness and lifestyle education. Work with our primary clinic and contracted dietician to increase referrals through primary care to the dietician service. Identify opportunity areas for increased referrals, collaborate with the dietician, and implement the plan. Increase patient knowledge regarding proper nutrition habits, helping improve overall health outcomes.Avera Hand County continued to address the community health needs identified in the community health needs assessment completed in 2018. The following actions were taken to address the identified needs:Disease prevention and maintenanceAvera Hand County Memorial Hospital, along with Avera Medical Group-Miller, has created a Facebook page to provide education for the public. Avera has assisted with educational information to be posted on a regular basis to keep the community informed. This tool has provided positive feedback in the past year with the pandemic. FY2022 Update: The Facebook page continued to be an excellent source to provide education to the public regarding disease prevention and health maintenance. The hospital and clinic distributed at least one healthcare conditional topic per month. In January 2022, the hospital and clinic participated in the local Farm and Home Show by offering immunization information, educational handouts on fall risk and balance impairments, and complimentary blood pressure checks. In an effort to improve access and safety to entering the wellness center, the Avera Hand County CHNA committee met with the local wellness center board to request the installation of an automatic door opener. The installation was complete in fall 2021.Access to Specialty CareThe need for more access to specialty providers and a local dialysis program were a top priority. While we have a number of specialists who do outreach here, there is a need for more. We implemented eCare access to social workers for mental health services and continued to work with Community Counseling services from Huron. The eConsult program was started to offer visits for specialty providers within the Avera system. FY2022 Update: Avera Hand County continues to utilize the eservices allowing for more access to specialty care in the community. The specialties available through eConsult platform include hepatology, gynecology, and gastroenterology. Virtual Psychiatry services are available through eEmergency/eBehavioral Health in the emergency department. This includes 24/7 access to psychiatry assessment and consult for emergency department patients.
Avera Merrill Pioneer HospitalPart V, Section B, Line 11: Avera Merrill Pioneer conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Avera Merrill Pioneer leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Merrill Pioneer is committed to addressing the following identified significant community health needs:1. Improving the mental health of the community 2. Obesity3. Improve utilization of preventative careThe following actions will be taken by the hospital in future years to address the community health priority areas.Improve access to Mental Health services in Lyon County- Screen all patients for depression or mental health care needs.- Continue to participate in the Lyon County Mental Health Coalition to discuss mental health amongst school age individuals.- Utilize the services available through the expanded Avera Behavioral Hospital.Provide services and promote a healthy lifestyle- Collaborate with local grocery store to provide healthy recipes for community members to utilize.- Provide education to promote healthy eating.- Collaborate with the City of Rock Rapids to provide additional exercise opportunities for the community.Provide preventative care services to promote the health of the community- Improve immunization compliance with patients.- Improve management of chronic health conditions.- Promote completion of preventative health screenings.Avera Merrill Pioneer decided to do an abbreviated CHNA in 2020 due to the COVID pandemic. By performing a second CHNA in 2022, Avera Merrill Pioneer was able to align with Avera McKennan's CHNA schedule. Due to the COVID pandemic, information was obtained utilizing different methods to limit the exposure of those collecting the data. The short timeframe between the two Community Health Needs Assessments made it difficult to effectively evaluate the impact the initiated interventions had on the health of the community the facility serves.The following actions were taken during FY2022 to address the needs identified, mental health, obesity and chronic health conditions, in the prior community health needs assessment:Telehealth equipment has been added to the Avera Medical Group Clinic to provide telehealth services for mental health counseling. This does not add to the number of mental health providers for Lyon County, but it does help bridge the gap in areas lacking Mental Health Providers professionals. Avera Merrill continues to screen for depression and mental health care needs for patients with each admission.Interventions were implemented to manage chronic health conditions and improve the quality of life of these individuals. Interventions implemented included promotion of physical activity, promotion and education related to healthy eating, identification of individuals with chronic health conditions to optimize their health care regimen, reviewing immunizations at clinic appointments and offering vaccines to eligible patients, and offering screening of chronic disease to improve quality of life through early treatment and management of disease process. Patients seen within the facility are assessed for diabetes and pre-diabetes. Patients diagnosed with diabetes/pre-diabetes are offered diabetic education classes with our facilities' diabetic educator and dietician. Patients are taught healthy eating, maintenance of blood glucose levels, maintenance of a healthy weight, and medication management of diabetes. Patients with chronic health conditions are referred to coordinated care upon discharge from facility to ensure that patients' care plans continue to be met post-discharge. These patients receive post discharge phone calls and follow-up appointments seven to fourteen days after discharge to ensure continued improvement in their condition.
Avera McKennanPart 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.
Heart Hospital of South Dakota, LLCPart 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 Gregory Healthcare CenterPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Milbank Area HospitalPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Dells Area Health CenterPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Flandreau Medical CenterPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Hand County Memorial HospitalPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Merrill Pioneer HospitalPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera McKennanPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Heart Hospital of South Dakota, LLCPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement.
Avera Gregory Healthcare CenterPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Milbank Area HospitalPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Dells Area Health CenterPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Flandreau Medical CenterPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Hand County Memorial HospitalPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Merrill Pioneer HospitalPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera McKennanPart 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.
Heart Hospital of South Dakota, LLCPart 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 Gregory Healthcare CenterPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Milbank Area HospitalPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Dells Area Health CenterPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Flandreau Medical CenterPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Hand County Memorial HospitalPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Merrill Pioneer HospitalPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera McKennanPart 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.
Heart Hospital of South Dakota, LLCPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Gregory Healthcare CenterPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Milbank Area HospitalPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Dells Area Health CenterPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Flandreau Medical CenterPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Hand County Memorial HospitalPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Merrill Pioneer HospitalPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Part V, Section B, line 7a:Hospital facility's website for CHNA:avera.org/about/community-health-needs-assessments/
Part V, Section B, line 10a:Hospital facility's website for Implementation Strategy:avera.org/about/community-health-needs-assessments/
Part V, Section A website addresses:Avera McKennanavera.org/locations/mckennan/Heart Hospital of South Dakota, LLCavera.org/locations/heart-hospital/Avera Milbank Area Hospitalavera.org/locations/profile/milbank-area-health-care-campus/Avera Gregory Healthcare Centeravera.org/locations/profile/avera-gregory-hospital/Avera Dells Area Health Centeravera.org/locations/profile/avera-dells-area-hospital/Avera Flandreau Medical Centeravera.org/locations/profile/avera-flandreau-hospital/Avera Hand County Memorial Hospitalavera.org/locations/profile/avera-hand-county-memorial-hospital/Avera Merrill Pioneer Hospitalavera.org/locations/profile/avera-merrill-pioneer-hospital/
Part V, Section B, line 11 Avera McKennan:Implementation Strategy continued for Avera McKennan and Heart Hospital of South Dakota, LLC:Avera McKennan and Heart Hospital of South Dakota, LLC continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.ACCESS TO CAREExpand patient transportation program. Review current partnerships and explore new opportunities with transportation providers.Workforce transportation pilot program. Conduct a pilot program to assist qualified staff with transportation on a case-by-case basis.Avera's transportation program slowed during Covid due to the lack of drivers in the market and the transition of in-person visits to virtual care. Overall, however, Avera's transportation program has expanded to include additional departments and users and continues to be an important community health benefit directed at reducing barriers to care. Avera's workforce transportation program has continued and is also utilized on a case-by-case basis for qualifying employees in high-needs areas. Additionally, Avera applied for and received grant funding to supplement paratransit services for patients accessing health care services located outside paratransit service boundaries. FY2022 Update: The Paratransit Grant project began service in the fall of 2021 and has expanded to include qualifying patients on an inpatient and outpatient basis. Avera continues to explore additional transportation options to address community and workforce needs.BEHAVIORAL HEALTH AND SUBSTANCE ABUSEInvestigate adding a 4th wing at Avera Behavioral HealthFY2022 Update: A new 4-story wing at Avera Behavioral Health opened in March 2022. The new wing will increase access to services for all ages and specifically include an additional child behavioral health unit, an adolescent addiction inpatient residential unit, bringing the senior unit onto the campus, adding four new adult beds, expanding the partial hospital program, and 24/7 psychiatric urgent care unit.Partner with Community-Based Triage Center. Support the development of a community-based triage center to assist residents in accessing resources for addiction treatment, behavioral health, and other needs.FY2022 Update: Opened community triage center "The Link" in partnership with Sanford, City of Sioux Falls, Minnehaha County and Avera. Avera BHS was chosen as the operator. Over 2,500 clients have benefitted from the services since opening on June 1, 2021.CHRONIC DISEASE PREVENTIONOne Sioux Falls Project. Address social determinants of health, seek opportunities to actively support the One Sioux Falls framework that includes accessible housing, engaging people, health and safety, and workforce development.FY2022 Update: Avera remains part of the One Sioux Falls Project and is a primary stakeholder in establishing the Community Health Needs priorities through a new CHIP (community health improvement program) process. One Sioux Falls established a guiding framework for addressing social determinants of health and improving the quality of life in the Sioux Falls area. The framework included four core elements: engaging people, workforce, safety & health, and accessible housing.FY2022 Update: Avera continues to offer the Planet Heart program in communities in their footprint. The Planet Heart program offers heart and vascular screening. The program, along with tests for cholesterol and other factors, help people know their numbers as they relate to cardiac health.Healthy Food Program. Pursue program designed to prevent and limit weight gain and improve overall physical health for qualified individuals in Avera's Coordinated Care Program.Food Education Program. Create education programming focused on selecting, storing and utilizing healthier food options. Partner with Healthy Weight Project. Pursue policy, system and environmental changes to maintain or increase the percentage of people living at a healthy body weight.Avera is committed to being our patients' partner in good health. Healthy eating and maintaining a healthy weight are important steps in good health. Avera has adopted policies to encourage healthy eating. All Avera McKennan kitchens always offer healthier meal options including, but not limited to, lean entrees, salads, sides and desserts. Food vendors must meet specific criteria to ensure the health and safety of customers and patients. Avera looks for local, fresh, and sustainable products to promote health and wellness of patients and the community. Vending machine operators are encouraged to offer healthier options. Avera has developed and promoted various healthy eating and weight loss education materials. Education materials can be found on the Avera website, in physician clinics, Avera hospitals, as well as various locations around the community. Avera hosts and participates in community events to educate and promote healthy eating and healthy weight lifestyles.
Part V, Section B, Line 16a, 16b, and 16c:www.avera.org/patients-visitors/charity-patient-assistance-programs/
FieldValueIRS element (for citing)
Facility42FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (42 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Avera McKennan Behavioral Health Center
4400 W 69th StSioux FallsSD57108Inpatient & Outpatient behavioral health services
2 - Avera Plaza 2 Pharmacy
1301 S Cliff AvenueSioux FallsSD57105Retail pharmacy
3 - Avera Prince of Peace
4500 S Prince of Peace PlaceSioux FallsSD57103Skilled nursing facility
4 - Avera McKennan Home Infusion
1020 S Cliff AvenueSioux FallsSD57105Comprehensive home infusion therapies & supplies
5 - McKennan Regional Laboratory
1325 S Cliff AvenueSioux FallsSD57105Laboratory services
6 - Avera Medical Group Worthington
1216 Ryans RoadWorthingtonMN56187Primary care clinic
7 - Avera Rosebud Country Care Center
300 Park AvenueGregorySD57533Skilled nursing facility
8 - Avera McKennan Fitness Center
3400 S Southeastern DriveSioux FallsSD57105Fitness center
9 - Avera 69th Street Pharmacy - Behavioral
4400 W 69th St Suite 300Sioux FallsSD57108Retail pharmacy
10 - Avera Medical Group Windom
820 - 2nd AvenueWindomMN56101Primary care clinic
11 - Avera McKennan Hosp & Univ Campus Pharm
1325 S Cliff AvenueSioux FallsSD57105Retail pharmacy
12 - Avera Institute for Human Genetics
4400 W 69th St Suite 200Sioux FallsSD57108Genetic research program
13 - Laurel Oaks Apartments
4510 S Prince of Peace PlaceSioux FallsSD57103Independent living apartments
14 - Avera Medical Group Sibley
600-9th Avenue NorthSibleyIA51249Primary care clinic
15 - Avera Research Institute
3720 W 69th StSioux FallsSD57108Clinical research studies
16 - Avera Dermatology Pharmacy
6701 South Minnesota AvenueSioux FallsSD57108Retail pharmacy
17 - Avera Medical Group Occupational Med
2100 S Marion RdSioux FallsSD57106Business and corporate health care clinic
18 - Avera Medical Group Women's Midlife Care
911 East 20th Street - Suite 200Sioux FallsSD57105Women's services clinic
19 - AveraNow Clinic
3000 S Minnesota AveSioux FallsSD57105Primary care clinic
20 - Avera Medical Group Big Stone City
451 Main StreetBig Stone CitySD57216Primary care clinic
21 - Hegg Medical Clinic Avera
2121 Hegg DriveRock ValleyIA51247Primary care clinic
22 - Health Care Clinic
300 North Dakota Avenue Suite 117Sioux FallsSD57104Free healthcare clinic
23 - Community Blood Bank
1301 South Cliff Avenue Suite 3Sioux FallsSD57105Community blood services
24 - Yorkshire Eye Clinic
2311 Yorkshire DriveBrookingsSD57006Ophthalmology and optometry clinic
25 - Avera Medical Group Estherville
926 North 8th StreetEsthervilleIA51334Primary care clinic
26 - Rural Medical Clinics
301 South Walnut StreetFreemanSD57029Primary care clinic
27 - Dakota Family Medical Center
101 South Front PO Box 27ChamberlainSD57325Primary care clinic
28 - Pipestone Medical Group Avera
920 - 4th Avenue SWPipestoneMN56164Primary care clinic
29 - Avera Medical Group McGreevy Salem
740 South HillSalemSD57058Primary care clinic
30 - Avera Medical Group Larchwood
916 Holder Street PO Box 8LarchwoodIA51241Primary care clinic
31 - Avera Medical Group Butte
730 Wilson StreetButteNE68722Satellite primary care clinic
32 - Avera Medical Group Elkton
203 Elk StreetElktonSD57026Satellite primary care clinic
33 - Avera Medical Group Fulda
201 N St Paul AvenueFuldaMN56131Satellite primary care clinic
34 - Avera Medical Group Lakefield
221 - 3rd AvenueLakefieldMN56150Satellite primary care clinic
35 - Avera Medical Group Volga
210 Kasan AvenueVolgaSD57071Satellite primary care clinic
36 - Avera Addiction Care Center
6140 S Curae LaneSioux FallsSD57108Addiction care facility
37 - Avera Human Performance
6800 S Louise AvenueSioux FallsSD57108Sports medicine and training facility
38 - Avera Medical Group George
101 N Main StreetGeorgeIA51237Primary care clinic
39 - AMG-McGreevy Dawley Farm Urgent Care
1035 South Highline PlaceSioux FallsSD571101000Urgent care
40 - AMG-McGreevy Family Hlth Ctr Urgent Care
2100 S Marion RdSioux FallsSD571063646Urgent care
41 - Avera on Louise Health Campus
6100 S Louise AveSioux FallsSD57108Inpatient & Outpatient Surgical Hospital
42 - Avera Pharmacy - SF Louise Avenue
6100 S Louise AveSioux FallsSD57108Retail pharmacy

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted.
Part I, Line 7:A combination of costing methodology was used to calculate the amounts reported in the table. A cost accounting system was used to calculate Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for our tertiary medical center. A cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate charity care at cost for all entities and Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for any operations outside of the tertiary medical center. For all other amounts, costs and revenues as reflected by the general ledger system were used.
Part I, Line 7g:Physician clinic costs for transplant services are included in subsidized health services. Revenue of $915,182 and costs of $3,163,731 were included for a net community benefit of $2,248,549. Our facility is the principal provider of bone marrow, pancreas, kidney and liver transplant services throughout our service area, with the clinics as a crucial component of successful pre- and post-transplant care.
Part II, Community Building Activities:The community building activities include monetary assistance to organizations that focus their efforts on providing neighborhood improvement projects in high needs areas, children and youth development programs, local economic development, and job creation and training programs.
Part III, Line 2:The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents.
Part III, Line 4:The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 17 and 18.
Part III, Line 8:The Medicare revenues received (line 5), allowable costs (line 6), and the resulting loss (line 7) does not include a significant portion of the Organization's expenses. These lines require use of the Medicare cost report as prepared by the required guidelines which disallows numerous costs of hospitals, particularly if they are part of an integrated system such as Avera McKennan. In these cases, the entity must file a home office cost report which "steps down" overhead to non-cost report entities disproportionately to actual allowable share and essentially removes the costs from the hospital's cost report entirely. Examples of a portion of these overhead costs would be finance, business office, information technology, human resources and administration. Examples of non-cost report entities operated by Avera McKennan include clinics, mobile imaging services, long-term care facilities, and other health care related businesses. There are also costs completely disallowed by cost report rules such as bad debt expense, hospitalists care, CRNA's, and interest expense. Avera McKennan also receives a Medicare Disproportionate Share Hospital (DSH) adjustment as part of the cost report due to its significant number of low-income patients served. Part III, line 5 requires inclusion of this revenue though expenses included are much lower. Schedule H instructions also require the exclusion of $9,642,591 of Medicare losses because they are included in Schedule H, Part 1, Line 7f or 7g. Including the Medicare percentage of disallowed costs, entities which don't file a cost report but nevertheless care for Medicare patients, and the impact of the home office cost report, the Medicare shortfall is $109,984,426 as opposed to a shortfall of $25,090,311.Avera McKennan follows the Catholic Health Association guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community.Medicare allowable costs of care are based on the Medicare cost report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare & 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:Community needs assessment occurs at various points in the system. Through annual strategic planning sessions, community leaders are brought in to update and educate Avera McKennan board members and administrative council on the successes, challenges, and service gaps in the community. Examples include community health workers, community health program leaders, community non-profit leaders, school district officials, state health department officials, and community health organizations. Leaders also serve on boards of various community organizations which seek to address the health and well-being of community members. Local governing boards of outlying facilities, who are members of the community, discuss and help direct resources to areas of targeted needs as well.
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 McKennan's service area is a largely rural population. Services are provided through a health care network of clinics, critical access hospitals and tertiary facilities covering communities in four states. The main tertiary facility is in a population center of over 196,500 served by another non-profit hospital of similar size, Veterans Administration Hospital, a hospital dedicated to diagnosis and treatment of heart disease, and a hospital for children with special health care needs. Outside of this population center, most of the communities served have less than 4,000 residents. The primary service area includes four counties covering approximately 2,600 square miles and contains seven federally designated medically underserved communities. Per the 2021 U.S. Census Bureau QuickFacts data, an average of 8.075% of residents in the primary service area are at or below the poverty level. Our secondary service area covers an additional 17 counties in South Dakota, Iowa, and Minnesota.
Part VI, Line 5:Surplus funds are reinvested in facilities to improve patient care.Medical staff privileges are extended to all qualified physicians in the community. The Avera McKennan Board of Trustees is principally comprised of community members from the primary service area. Members come from a variety of backgrounds ranging from private industry and banking to healthcare.Avera McKennan is a verified Level II trauma center and was the first such Center in the State of South Dakota. Avera McKennan's Emergency Department is staffed 24 hours a day with board-certified emergency specialists and provides emergency care regardless of ability to pay. Avera McKennan had 38,730 Emergency Department visits in FY 2022. Operating both Fixed Wing and Helicopter medical air transports, Avera McKennan's flight teams cover a large geographic area providing state-of-the-art air transport services and access to critical care, with 2,627 flights in the past year.Health Care Clinic: In 1992, Avera McKennan established a Health Care Clinic to provide free care for people who are uninsured or underinsured in the community. The clinic is managed by a Registered Nurse and staffed by Registered Nurses, two midlevel providers, medical residents and volunteer health care providers. The goal of the clinic is to prevent or treat patients' medical conditions before they become catastrophic. The clinic averages 366 visits per month. The clinic provides preventative care, diagnosis and treatment of illnesses and injuries, medication assistance and assistance in obtaining specialist care for patients with complex cases. The clinic also serves to train physicians, nurses and other health care students. It provides a free evening clinic one evening per month, staffed by medical students under supervision of physicians. Avera McKennan is the only health care organization to provide free services such as this in the state of South Dakota. The clinic had 4,394 visits in 2022 and was operated at an annual cost of $1,176,955. Partnership in Live Well Sioux Falls: The City of Sioux Falls received a Community Health Transformation Grant from the South Dakota Department of Health, sparking a project to improve the health and well-being of the citizens of Sioux Falls. Guided by the City of Sioux Falls Health Department, this ongoing project is known as Live Well Sioux Falls. It involves more than 24 community partner organizations. Among these partners are Avera McKennan and the other major health care system in Sioux Falls, Sanford Health. Avera plans to work in partnership with the City of Sioux Falls and Sanford Health to address the priorities of Live Well Sioux Falls and arrive at solutions which are collaborative in nature.Avera McKennan collaborates with Live Well Sioux Falls to promote the Big Squeeze, a hypertension initiative in April to promote blood pressure screening and education, with the goal of diagnosing high blood pressure. One in three American adults have high blood pressure, but only half of them have it under control, adding to the risk of stroke, heart attack and vascular disease.Residency/Health Professions Training and Internships: In 2021, Avera McKennan had approximately 55 medical residents in training at Avera McKennan in Internal Medicine, Family Practice, Psychiatry, Geriatrics and Transitional Residency Programs offered in partnership with the University of South Dakota School of Medicine. Over 1,000 students in medicine, nursing, pharmacy, physician assistant programs, medical assisting, radiology and respiratory therapy also completed clinical rotations at Avera McKennan. In non-clinical areas, Avera McKennan offers paid and nonpaid internships in the areas of research, finance, administration, therapies, exercise science and social work. Avera McKennan is currently legally affiliated with approximately 158 institutions of higher education.Patient and Community Education: Avera McKennan is a regional leader in offering educational programs for a variety of learners, leaders and employees. Utilizing advanced technology, many of these programs are provided electronically throughout the tri-state area. Educational sessions are offered to medical staff, employees, health care professionals, students at all levels and the general public. Utilizing Avera McKennan's Education Center, a broad cross-section of classes involving diverse audiences are provided as a community service each year.1. Online resources: Avera McKennan offers vast free patient educational online resources on its public website on numerous health topics, with suggestions for lifestyle change, behavior modification and management for improved health.2. To Be Well free education events were held on topics including orthopedics, cancer, diabetes, weight loss/healthy eating, multiple sclerosis, anxiety and acupuncture. 3. Forums: The Avera Behavioral Health Center offers free Friday Forums, in which school counselors and therapists are invited to presentations on children's mental health topics such as conflict cycles, reactive attachment disorder, depression and bipolar disorder in children, and teen substance use, abuse and addiction. 4. The Avera Behavioral Health Center offers free monthly educational sessions on various topics followed by discussion for adults who have been impacted by a loved one's mental illness. Topics have included grief and loss, anxiety, and parenting strategies for managing challenging behaviors.5. Women's & Children's Services: Avera McKennan's Women's & Children's Services offers a number of parenting and community education opportunities, for free or at a minimal cost. In fiscal year 2022, 52 childbirth education classes were held with 194 attendees. A total of 16 parent and family education classes were held with 249 attendees. A total of 55 car seats were issued through the South Dakota Child Safety Seat Distribution Program. Free burn education was provided to 6,055 students during presentations in schools.6. Daycare training: Free of charge, Avera McKennan offers two in-service training sessions per month to daycare providers through EmBe, with a total of 12 scheduled annually, and additional sessions for requested topics. Support groups: Avera McKennan offers approximately 10 free support groups. They range in topic from cancer to liver disease, diabetes, bone marrow transplant, stroke and grief and loss. The organization provides free meeting space as well as speakers and leaders. Information and Assistance: Avera McKennan operates a 24-hour Medical Call Center, through which patients have access to nurse triage at no cost to the patient. Patients can call a toll-free number and talk personally with a Registered Nurse to ask health questions or receive general health information. Avera McKennan's web site also provides an extensive health library that consumers can access free of charge.Interpreter service: Avera McKennan employs two full-time, two part-time and one PRN Spanish interpreter in-house, and also employs two Community Outreach Consultants that can serve as interpreters for Arabic, Amharic, Oromo, Russian and Kunama. Their services are offered to patients free of charge. In addition, in cooperation with external agencies, Avera McKennan is able to handle 210 different languages and dialects through phone, video remote interpreting and other means. Interpretation services are available for patients when they are at Avera McKennan in person, or when they call by phone. All the above services are provided at no cost to the patient.Transport to Transplant: Avera McKennan developed the Transport to Transplant project, which removes transportation barriers for patients from rural areas which may prevent them from completing the evaluation and testing needed for kidney and/or pancreas transplant. A van funded through a grant from the Avera McKennan Foundation is used to transport patients who demonstrate a financial need. Patients are brought to the Avera Transplant Institute for a condensed multi-day evaluation with all testing and visits completed in less than one week. Ultimately, the project results in improved morbidity and mortality, as kidney transplant doubles patient survival as compared to remaining on dialysis.Continued below.
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.
Part VI, Line 5, continued:Avera Family Wellness: This program is designed to support families and children in need of early intervention mental health services. The families have direct access to mental health services when needed. This program combines positive activities like mental health therapy (our therapists are specifically trained in dealing with high need families, a variety of play therapies and addressing issues of childhood trauma), psychiatry, family and school coordination and classroom enrichment services. Referrals come from the early childhood program, as well as our four partner elementary schools. The goal is to lessen the number of adverse childhood experiences to improve the chances for children living in poverty to be successful in school and in life. Families with the most difficult situations are being referred by the school district. We have plans to increase our staff to grow this program as we will see now more than ever, there is a need for these services due to the impact of COVID-19 and other stressors in our community, schools and families.The Walsh Family Village: This hospitality house complex adjacent to the Avera McKennan campus provides a home away from home for patients and their families who come for care at Avera McKennan from outside of Sioux Falls. The project was funded by donations and is operated by Avera McKennan. Eleven guest rooms are available. Avera McKennan also donates use of the building in the complex for a Ronald McDonald House for families of pediatric patients. If they can afford it, guests are charged a low fee per night. Guests are not turned away due to inability to pay the fee. Employees regularly donate non-perishable food items to stock a food pantry for guests. In fiscal year 2022, the Walsh Family Village served 430 guests, staying in 1,959 nightly rooms, a 77.76% occupancy. Avera McKennan provides a subsidy of approximately $128,336 per year to operate the hospitality complex. Prevention and support of substance use disorder: Avera McKennan is a partner with Face it TOGETHER, Inc., a nonprofit organization which serves as the local face and voice of recovery from addiction through its recovery support services, advocacy and awareness programs. Avera has been a partner with Face it TOGETHER since its inception, and in a recent awareness campaign.Community Connections: Avera McKennan reaches out to people and communities throughout eastern South Dakota, southwestern Minnesota and northwest Iowa through Home Town Connections. Providing a critical feedback link to local referring doctors, this program completes the communications link necessary to keep local health care providers current on the treatment of their patients at Avera McKennan.Support of the arts and cultural life: Avera McKennan hosts Sioux Falls' only indoor SculptureWalk. Artists donate sculptures for one year, which are placed at locations throughout Avera McKennan's campus, in buildings connected by skywalks. Brochures contain a map, and visitors who follow the route suggested walk approximately 1 mile, making this a healthy as well as a cultural journey.Community Benefits: Avera McKennan provides additional community benefits including: support of youth programs; homeless programs; community arts programming; health prevention; awareness and education about cancer, heart disease and other conditions; and support of the Sioux Empire United Way and other services in the region. All the programs did continue at least virtually during the pandemic. All our partners were able to be nimble and deliver services in new and creative ways, always keeping safety at top of mind during the pandemic.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

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

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
Scholarships29$38,946
Assistance with medical expenses3934$512,162

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe governing board and management develop programs which enhance the charitable mission of the Organization. Disbursement for grants or assistance for these programs are made in accordance with prescribed procedures and are subject to conditions established by the Organization's governing board and management, which are designed to ensure that individuals and organizations receiving grants or assistance are adequately investigated to ensure that they are qualified recipients.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Todd Zimprich MD
Neurology$855,062$0$959,691$0$20,772$0$14,500$0$32,914$0$1,882,939$0$0$0
Richard Conklin MD
Hematology/Oncology$1,404,282$0$9,100$0$28,109$0$14,500$0$40,940$0$1,496,931$0$0$0
Alex Linn MD
Neurology$979,153$0$373,743$0$90,358$0$14,500$0$30,915$0$1,488,669$0$0$0
Travis Liddell MD
Surgery/Orthopedics$1,038,026$0$193,240$0$126,290$0$14,500$0$37,191$0$1,409,247$0$0$0
Brian Knutson MD
Dermatology$1,059,836$0$232,378$0$9,532$0$14,500$0$30,914$0$1,347,160$0$0$0
David Flicek
President$0$1,254,501$0$10,650$0$25,975$0$14,500$0$30,702$0$1,336,328$0$0
Julie Lautt
CFO Avera Health; Sec/Treas$0$1,032,072$0$10,440$0$8,716$0$14,500$0$1,694$0$1,067,422$0$0
Cristina Hill Jensen MD
Board Trustee/Gastroenterology$728,663$0$115,824$0$6,052$0$14,500$0$32,414$0$897,453$0$0$0
Jawad Nazir MD-Board Trustee
Infectious Disease & Internal Med$520,133$0$134,124$0$6,329$0$14,500$0$33,664$0$708,750$0$0$0
Michael Elliott - Sr Vice
President Medical Affairs/CMO$533,578$0$285$0$5,766$0$14,500$0$31,255$0$585,384$0$0$0
Jared Friedman MD
Board Trustee/Chief of Staff$0$512,162$0$240$0$2,966$0$14,500$0$40,230$0$570,098$0$0
Lori Popkes
Sr Vice President$384,052$0$285$0$4,908$0$11,791$0$32,754$0$433,790$0$0$0
Curtis Hohman
Sr Vice President$382,864$0$5,480$0$12,660$0$14,500$0$11,070$0$426,574$0$0$0
Rick Kooima MD
Board Trustee/Chief of Staff$268,353$0$22,825$0$6,597$0$14,500$0$32,914$0$345,189$0$0$0
Steve Petersen - Former Key
Employee VP-Pharmacy$0$139,372$0$0$0$148,019$0$14,394$0$15,249$0$317,034$0$0
Alisa Reindl MD
Board Trustee/Family Medicine$204,484$0$32,885$0$2,369$0$11,995$0$11,056$0$262,789$0$0$0
Sandra King
Director Operative Services$186,098$0$9,616$0$2,867$0$9,878$0$10,700$0$219,159$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4aSteve Petersen received $136,074 as a former key employee VP Pharmacy.
Schedule J, Part I, Line 3:The President is compensated by Avera Health. Avera McKennan relied on the related organization for determining the compensation for the President using the methods described in Part I, Line 3.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Deann Matthiesen
Family of Key Employee$140,537Employee compensation0
Kristy Mickelson
Family of Key Employee$40,166Employee compensation0
Grant Flicek
Family of Officer and Board Trustee$99,128Employee Compensation0
Ashley Steffen
Family of Former Key Employee$90,040Employee Compensation0
Kelsey Knecht
Family of Board Trustee$51,265Employee Compensation0
Tina Lautt
Family of Officer$52,416Employee Compensation0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 2A new four-story wing on the Avera Behavioral Health Hospital was opened adding several new and enhanced services for children, youth, adults and seniors. The services include 24/7 Behavioral Health Urgent Care, 23-Hour observation care, residential addiction care for youth, partial hospitalization services for youth and specialized care unit for children and adolescents. The new wing also houses the Avera senior behavioral unit which will allow for continuity of mental health services while enhancing and expanding the behavioral health program.
Form 990, Part VI, Section A, line 2David Flicek, Steve Petersen, Jared Friedman, MD and Julie Lautt have a business relationship.
Form 990, Part VI, Section A, line 6The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under section 501(c)(3) of the Internal Revenue Code of 1986, as amended.
Form 990, Part VI, Section A, line 7aAvera Health, as the sole member, has the power to appoint and remove, with or without cause, all members of the board of directors.
Form 990, Part VI, Section A, line 7bAvera Health, as the sole member, has the following rights as the Member: 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. 16) To initiate and give final approval to equity and asset transfers by and between the Member and the Corporation and any affiliates or subsidiaries of the Member. 17) To initiate and give final approval to (i) any and all issuances of obligations under any existing or future master indentures binding the Corporation, any indebtedness (including, without limitation, capitalized leases) in excess of dollar thresholds as may be from time to time established by the Member, and (ii) any pledges of collateral for such indebtedness and any pledges of real estate as collateral for any indebtedness regardless of amount. 18) Full and exclusive power to execute supplemental master indentures, including, without limitation, those authorizing the issuance of obligations or series of obligations, (ii) full and exclusive power to prepare, or authorize the preparation of, any and all documents, agreements, swap agreements, investment contracts, certificates and disclosure materials (including, without limitation, Official Statements and any supplements thereto) reasonably and ordinarily prepared in connection with the issuance of obligations thereunder, or related bonds associated therewith and to execute and deliver such items to the appropriate parties in connection therewith and (iii) full and exclusive power to authorize the entrance of members to, or withdrawal of members from, any obligated group, subject to the other requirements of the applicable master indenture for such entrance or withdrawal.
Form 990, Part VI, Section A, line 8bAvera does not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe Form 990 is reviewed by the Avera Health VP of Financial Reporting, Tax Manager, Facility CEO and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders.
Form 990, Part VI, Section B, line 12cThe Conflict of Interest Policy covers Board members, officers, and key employees. At each board meeting, a request is made for all Board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The Declaration of Conflict of Interest is recorded in the meeting minutes. The Board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the Board.
Form 990, Part VI, Section B, line 15bThe CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera McKennan.
Form 990, Part VI, Section C, line 19The Organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public.
Form 990, Part VI, Section B, Line 16b:There is no written policy or procedure requiring the Organization to evaluate its participation in joint venture arrangements. 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 must be approved by the board and the member.
Form 990, Part IX, line 11gCentralized services: Program service expenses 37,257,903. Management and general expenses 106,818,333. Fundraising expenses 0. Total expenses 144,076,236. Purchased services: Program service expenses 91,920,597. Management and general expenses 2,132,627. Fundraising expenses 45,482. Total expenses 94,098,706. Medical professional fees: Program service expenses 19,628,955. Management and general expenses 33,967. Fundraising expenses 0. Total expenses 19,662,922.
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:Capital transfers, net 767,558. Other changes in unrestricted net assets 313,544. Change in interest of Avera Health Foundation -5,051,628.
Form 990, Part XII, Line 2c:The Audit Committee of Avera Health, parent organization of Avera McKennan, selects the auditor and reviews the consolidated audited financial statements for Avera Health, which inclues Avera McKennan.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Sioux Falls Hospital Management LLC
1325 S Cliff Ave PO Box 5045Sioux FallsSD571175045562141521Management company of Heart HospitalNC$2,870,694$19,565,415West 69th Street LLC
West 69th Street LLC
1325 S Cliff Ave PO Box 5045Sioux FallsSD571175045460224743Holding companySD$2,870,694$19,565,415Avera McKennan
Alumend LLC
1325 S Cliff Ave PO Box 5045Sioux FallsSD571175045460224743Research and developmentSD-$2,780,973$47,817,022Avera McKennan
MRIS LLC
1325 S Cliff Ave PO Box 5045Sioux FallsSD571175045470874983Healthcare ServicesSD$0$0Avera McKennan

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Avera St Anthony's Hospital
300 N 2nd StreetONeillNE68763470463911Healthcare ServicesNE501(c)(3)Line 3Avera Health0
Avera Holy Family
826 North 8th StreetEsthervilleIA51334420680370Healthcare ServicesIA501(c)(3)Line 3Avera Health0
Holy Family Hospital Foundation
826 North 8th StreetEsthervilleIA51334421317452Support Health Related ServicesIA501(c)(3)Line 10Avera Holy Family0
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare ServicesSD501(c)(3)Line 3Avera Health0
St Benedict Health Center Foundation
West Glynn Drive PO Box BParkstonSD57366460458725Support Health Related ServicesSD501(c)(3)Line 12a, ISt Benedict Health Center0
Avera Health
3900 West Avera Drive STE 300Sioux FallsSD57108460422673Promotion of HealthSD501(c)(3)Line 100N/A
Avera Queen of Peace
525 North FosterMitchellSD57301460224604Healthcare ServicesSD501(c)(3)Line 3Avera Health0
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare ServicesSD501(c)(3)Line 3Avera Health0
Avera Gettysburg
606 East GarfieldGettysburgSD57442460234354Healthcare ServicesSD501(c)(3)Line 3Avera St Mary's0
Avera at Home
5116 S Solberg AveSioux FallsSD57108460399291Home ServicesSD501(c)(3)Line 10Avera Health0
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare ServicesSD501(c)(3)Line 10Sacred Heart Health Services0
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare ServicesSD501(c)(3)Line 3Avera Health0
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare ServicesSD501(c)(3)Line 3Avera Health0
Avera Marshall
300 S Bruce StreetMarshallMN56258410919153Healthcare ServicesMN501(c)(3)Line 3Avera Health0
Avera Tyler
240 Willow StreetTylerMN56178410853163Healthcare ServicesMN501(c)(3)Line 3Avera Marshall0
Avera Health Plans Inc
3900 West Avera Drive STE 300Sioux FallsSD57108460451539Health Financing and Health Plan AdminSD501(c)(4)Avera Health0
Avera Granite Falls
345 10th AveGranite FallsMN56241843156881Healthcare ServicesMN501(c)(3)Line 3Avera Marshall0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 Lincoln St NELemarsIA51031820582350Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Sioux Center LLC
38 19th St SWSioux CenterIA51250753203100Medical Services - Home Medical EquipmentSDN/A00
Surgical Associates Endoscopy Clinic LLC
310 S Pennsylvania StAberdeenSD57401460461429Surgical AssociatesSDN/A00
Avera HME of Spencer Hospital LLC
2400 S Minnesota Avenue 102Sioux FallsSD57117800619999Medical Services - Home Medical EquipmentSDN/A00
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare ServicesSD00Avera McKennanRelated$5,741,388$39,130,8300.66670
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101BrookingsSD57006453204123Medical Services - Home Medical EquipmentSDN/A00
Caravan Health ACO 41 dba Prairie View Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153821447782Accountable Care OrganizationMON/A00
Avera Home Medical Equipment of Lakes Regional Healthcare LLC
2301 Hwy 71 South Ste DSpirit LakeIA51360862949748Medical Services - Home Medical EquipmentIAN/A00
Caravan Health ACO 15 LLC dba Prairie Vista Care Organization
7509 NW Tiffany Springs Parkway SteKansas CityMO64153611843657Accountable Care OrganizationMON/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Accounts Management Inc
5132 S Cliff Ave Suite 101Sioux FallsSD57108460373021Collection AgencySDN/AC0
Avera Property Insurance Inc
1000 West 4th Street Suite 1YanktonSD57078460463155InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental Real EstateSDN/AC0
Alucent Biomedical Inc
675 S Arapeen Dr Ste 102Salt Lake CityUT84108471818349BiotechnologySDCYes (1)Alumend LLC-$13,719,318$13,866,4340.65410
South Dakota State Medical Holding Company Inc
5300 South Broadband LaneSioux FallsSD57108460401087InsuranceSDN/AC0
DakotaCare Administrative Services Inc
5300 South Broadband LaneSioux FallsSD57108460424322InsuranceSDN/AC0
Alucent Australia Pty Ltd
Biotech ResearchYes (1)Alucent Biomedical Inc-$399,015$137,2440.65400Level 10 30 Collings StreetMelbourneVIC 3000ASAS
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera Heart Hospital of South Dakota LLC
R$3,155,296Intercompany detail from GL
Avera Heart Hospital of South Dakota LLC
S$7,544,972Intercompany detail from GL
Avera Heart Hospital of South Dakota LLC
L$2,540,275Intercompany detail from GL
Avera Heart Hospital of South Dakota LLC
Q$1,389,321Intercompany detail from GL