2025-05-14T14:18:58-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 460226738 St Benedict Health Center STBE 6059283311 401 West Glynn Drive Parkston SD 57366 Julie Lautt CFO Avera Health 6059283311 2025-05-09 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-04-25 2023 2025-03-06 01:10:19Z Avera St Benedict Health Center Lindsay Weber 401 West Glynn Drive Parkston SD 57366 32752398 0 0928 X See Schedule O X 1965 SD Promotion of health 11 9 227 56 0 0 799203 133610 28873413 31470965 448667 1115355 35792 32468 30157075 32752398 34589 41414 0 0 14242895 14853445 0 0 0 9319008 10010900 23596492 24905759 6560583 7846639 77515596 91102662 1601314 1741323 75914282 89361339 X Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. 0 0 22945143 41414 31489836 Avera St. Benedict Health Center's (Avera St. Benedict) mission is to provide healthcare services to Parkston, Tripp and Lake Andes, South Dakota residents and residents of the surrounding area. Avera St. Benedict is a 501(c)(3) organization affiliated with Avera Health. Avera St. Benedict consists of a 25-bed critical access hospital, a 49-bed nursing home, a 25-bed assisted living center and three provider-based clinics. Services offered by Avera St. Benedict include primary care, emergency, general surgery, orthopedic surgery, podiatry surgery, cardiac rehab, pain management, pharmacy, behavioral health, laboratory, imaging, telemedicine, wellness center, speech therapy, physical therapy, and occupational therapy. Avera St. Benedict provides acute care and long-term healthcare services.Following is a breakdown of these statistics by facility:Avera St. Benedict Hospital 374 Acute patient discharges 50 Newborn patient discharges 156 Swing bed patient discharges 19,843 Outpatient visits 1,411 Swing-bed patient days 82 Newborn patient days 22,889 Clinic visitsAvera Bormann Manor 17,493 Nursing home resident days 25 Long Term Care patient dischargesAvera St. Benedict 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 $1,200,167.Avera St. Benedict 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 St. Benedict upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera St. Benedict 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. 22945143 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 35 0 1 227 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Lindsay Weber President/CEO 40.00 1.00 X X 0 145343 43244 Antoinette VanderPol MD Chair/Family Medicine/OB 42.00 0.00 X X 328382 0 29884 Barb Weidenbach Vice Chair 2.00 0.00 X X 0 0 0 Bob Just Secretary 2.00 0.00 X X 0 0 0 Richard Boettcher Board Member 2.00 0.00 X 0 0 0 Sr Pam Donelan Board Member 2.00 5.00 X 0 0 0 Adam Fischer Board Member 2.00 0.00 X 0 0 0 Mary Haag Board Member 2.00 0.00 X 0 0 0 Sr Denette Leifeld Board Member 2.00 0.00 X 0 0 0 Patrick McCann Board Member 2.00 0.00 X 0 0 0 Pat Reiner Board Member 2.00 0.00 X 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1203675 19401 Paul Berndt MD Family Practice/OB Physician 40.00 0.00 X 411628 0 56954 Jedd Bialas CRNA 40.00 0.00 X 244964 0 47954 Larissa Sanger MD Family Practice/OB Physician 40.00 0.00 X 319424 0 53014 Beth Schroeder Manager - Clinic 40.00 0.00 X 203383 0 32080 Jason Wickersham MD Family Practice/OB Physician 40.00 0.00 X 463101 0 50160 1970882 1349018 332691 15 0 1 0 Avera Health 3900 W Avera Dr Sioux Falls SD 57108 Shared Services 1922322 Cassling Diagnostic Imaging Inc 13808 F St Omaha NE 681371102 Maintenance Contract & Repairs 170868 Avera Queen of Peace 525 North Foster Street Mitchell SD 57301 ITS, Administrative & Management Fees 160353 Avel eCare Medical Group PC 4500 N Lewis Ave Sioux Falls SD 57104 Clinical Services 133874 4 41637 87809 4164 133610 Patient & Resident Service Revenu 621110 29094395 29094395 Pharmacy Revenue 456110 1879384 1879384 Patient and Clinic Revenue 621110 272985 272985 224201 224201 31470965 20532 20532 13597 0 13597 13597 13597 1093808 1015 0 0 1093808 1015 1094823 1094823 AR Interest Income 900099 18871 18871 18871 32752398 31489836 0 1128952 X 14414 14414 27000 27000 346518 346518 11358337 11138040 220297 438521 432333 6188 1939346 1883536 55810 770723 755587 15136 36656 36656 883 883 3750858 2454745 1296113 9657 9557 100 246053 178412 67641 93108 92348 760 391404 347814 43590 32906 31795 1111 29245 27830 1415 1434741 1288721 146020 112049 36633 75416 Medical Supplies 3801373 3781896 19477 Equipment Lease/Rental 11985 11685 300 59982 49623 10359 24905759 22945143 1960616 0 329688 -62857 2646893 3168764 289787 265432 100533 79798 28348739 18412884 10629826 9935855 62995924 76225032 522945 1490638 77515596 91102662 1528363 1709596 31084 0 4405 3760 37462 27967 1601314 1741323 X 75080651 88446543 833631 914796 75914282 89361339 77515596 91102662 X 7846639 5385815 214603 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 883 883 0 Part II-B, Line 1: St. Benedict Health Center paid dues to organizations which have a portion of the dues attributed to lobbying activities. 0 1 X 87282 8133 3230 92185 82308 5203 229 87282 92814 -8774 1732 82308 82361 12923 2470 92814 82871 -297 213 82361 0.17604 0.61046 0.21351 0 1 1 97483 97483 18077395 10717159 7360236 9548963 7336940 2212023 624898 358785 266113 9935855 Avera Pooled Investments 74229079 F Interest in Avera Health Foundation 1995953 F 76225032 Right of Use Operating Lease Obligations 27967 27967 X Part IV, Line 2b: Funds are held on behalf of the residents. 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. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 468668 468668 0.01880 1083089 1011498 71591 0.00290 76421 50516 25905 0.00100 1628178 1062014 566164 0.02270 16121 2500 13621 0.00050 32795 32795 0.00130 1671675 1192931 478744 0.01920 33844 20805 13039 0.00050 1754435 1216236 538199 0.02150 3382613 2278250 1104363 0.04420 94 94 0.00000 12850 12850 0.00050 9302 9302 0.00040 7 7 0.00000 22253 22253 0.00090 1 0 7563370 7571613 -8243 X 1 1 1 1 Avera St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 See Part V Section C 50749 X X X X 3 provider based clinics St Benedict Hospital Inc 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V Section C X See Part V Section C X 1 21 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 St. Benedict Hospital Inc. Part V, Section B, Line 5: A variety of individuals and groups of people were involved in the CHNA process from November 2021 through February 2022. Qualitative data was obtained from questionnaires and interviews with the Hutchinson County Community Health Nurse, Ministerial Association member, Trojen Den organizer, Parkston School District teacher and superintendent, local daycare provider, low-income patient, local business representative, American Legion Post 194 representative, and a Hutterite Colony boss. Each of these were chosen to represent a cross section of the community and to adequately assess the needs of underserved populations. A survey (electronic and paper) was completed by 98 community members. St. Benedict Hospital Inc. Part V, Section B, Line 11: Avera St. Benedict conducted a community health needs assessment during FY2022. The CHNA committee discussed the health needs identified during the community health needs assessment and prioritized the needs based on the following criteria: estimated feasibility for the health care center to address the issue with current resources, importance the community placed on the need, burden, scope, severity, or urgency of the health need, and health disparities associated with the need.Through the assessment process, the following needs were determined to be of highest priority: *Cancer prevention screening *Improving access to care through better dissemination of resource materials *Accident prevention *Substance abuse/alcohol use preventionCANCER PREVENTION SCREENINGFY2024 Update: Pretty in Pink Women's health event was held to promote cancer screening. A fundraising event was also held during this time with donations supporting the Avera St. Benedict Cancer Fund held at Avera Health Foundation. A cancer fund within the Avera Health Foundation has been established with resources benefiting any patients who need financial assistance with diagnosis or treatment of a cancer diagnosis.IMPROVING ACCESS TO CARE THROUGH BETTER DISSEMINATION OF RESOURCE MATERIALS Avera St. Benedict has developed healthcare access guides and made them available at the hospital clinics. ACCIDENT PREVENTIONFY2024 Update: Avera St. Benedict implemented the Bike Rodeo and performed a babysitting clinic for youth in the clinic which helps to teach life skills to help educate and prevent accidents. In addition, Avera St. Benedict provided water safety training along with life jackets and water safety devices to a local Hutterite colony to help prevent accidental drownings. SUBSTANCE ABUSE/ALCOHOL USE PREVENTIONFY2024 Update: Substance Abuse/Alcohol Education "Too Good for Drugs" is being provided by the Licensed Behavioral Health Counselor to the 5th grade class at the Parkston School District to educate on substance abuse and prevention. In addition, Avera St. Benedict continues to offer licensed behavioral health counseling and most recently began psychiatry outreach every Monday. The following health needs were identified but will not be addressed: lifestyle choices, poverty, and socioeconomic issues. As a health care organization, there are limits to what can be addressed regarding lifestyle choices, poverty, and socioeconomic issues. Due to feasibility, these issues will not be directly addressed. St. Benedict Hospital Inc. Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. St. Benedict Hospital Inc. Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. St. Benedict Hospital Inc. Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. St. Benedict Hospital Inc. Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. Schedule H Part V, Section B, Lines 7a, 7b and 10a: avera.org/about/community-health-needs-assessments Schedule H Part V, Section B, Lines 16a, 16b and 16c: avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ Schedule H Part V, Section A organization's website: avera.org/locations/profile/avera-st-benedict-health-center/ 2 1 - Avera Bormann Manor 501 North 4th Street Parkston SD 57366 Nursing Home 2 - Avera St Benedict Assisted Living 400 W Fir Parkston SD 57366 Assisted Living Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 6a: The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/. Part I, Line 7: Charity care expense was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the FY2023 cost report. Subsidized health services were calculated based on a combination of the FY2023 Medicare cost report and an overall cost-to-charge ratio for certain expenses. Other means tested government programs, community health improvement services, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded in the general ledger. Part II, Community Building Activities: Avera St. Benedict Health Center provided donations to various organizations to support activities as listed on Part II. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. During the year ended June 30, 2024, the Organization adjusted the qualifying criteria under the charity care policy, which resulted in a reclassification of accounts considered bad debt in previous years that now qualified as presumptive charity care under the adjusted policy. Implicit price concession for the year of $196,025 was reduced for prior year reclassfications of $801,068 resulting in a negative implicit price concession of $605,043. Due to the negative implicit price concession per the general ledger, an amount of $0 has been reported on Line 2. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 19 and 20. Part III, Line 8: Avera St. Benedict provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. Medicare allowable costs of care are based on the FY2023 Medicare cost report. The FY2023 Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: If the patient qualifies for the Organization's financial assistance policy for low-income, uninsured patients and is cooperating with the Organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. Part VI, Line 2: Community needs are evaluated and assessed on an on-going basis in several ways. ASBHC has completed formal "needs assessments" several times over the course of the past several years. This has been accomplished with input from focus groups, surveys, short- and long-range planning by the Health Center Board as well as demographic and health care data analysis. In addition, regular meetings with the provider staff, and collaboration with the local school and churches, as well as local law enforcement help to address community needs. Part VI, Line 3: Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs. Part VI, Line 4: Avera St Benedict is a 25-bed critical access hospital in Parkston, South Dakota. The primary service area is defined as Hutchinson County, South Dakota, including the communities of Freeman, Menno, Olivet, and Tripp. Olivet is the county seat. Agriculture is the primary economic driver in the county. According to the U.S. Census Bureau QuickFacts July 2023 data, the population of Hutchinson County was just over 7,300 people and is predominately White/Caucasian at 95%. 21.8% of the population is over the age of 65. The median household income is $74,459 with a 9.8% povery rate. Uninsured individuals under age 65 is estimated at 9.1%. Per the South Dakota Department of Labor & Regulation, Hutchinson County has an unemployment rate of 2.0% compared with the state of South Dakota's 1.9% unemployment rate as of June 2024. The secondary service area, including portions of Douglas, Davison, Bon Homme, Hanson, and Charles Mix Counties are demographically similar to Hutchinson County with rural, agricultural lifestyles. According to the U.S. Census Bureau QuickFacts July 2023 data, Charles Mix County is different from the rest of the service area in that there is a 30.6% Native American population, median household income of $64,850 with a 21.4% poverty rate. Per the South Dakota Department of Labor & Regulation, Charles Mix County has an unemployment rate of 2.3% compared with the state of South Dakota's 1.9% unemployment rate as of June 2024.Avera St Benedict is the primary medical provider for 8 Hutterian Brethren Colonies in the primary and secondary service area, which includes about 550 individuals. Part VI, Line 5: The Organization's governing body is comprised of volunteer members who reside in the community. The Board of Directors meets bi-monthly and has community representation that brings forward issues relative to challenges, needs, and services within the community. The local ministerial group meets monthly at the Hospital and identifies needs and gaps within the parishioners they serve. The medical staff, including the physicians/mid-levels/department directors, have a monthly opportunity to meet and discuss ways to meet the needs of the community they serve. Surplus funds are reinvested in facilities to improve patient care. The Hospital operates an emergency room that is available to all, regardless of ability to pay.ASBHC has a fitness center on campus that is available to help the community focus on wellness and prevention. This endeavor is subsidized by the facility to improve the health and well-being of the community as a whole. The chaplaincy mission services participate and spearhead many community projects including an angel tree at Christmas to address the needs of children in our service area. ASBHC also donates to the local food pantry. There are several other projects of this nature on a smaller scale at the local school system. ASBHC donates to community events such as American Cancer Society projects and sponsors health related educational programs to the community at large. Avera St. Benedict also provides medical, nursing, and other ancillary health professions the opportunity for hands on learning experiences through residencies, internships, clinical rotations, and other shadowing and profession mentoring programs to help with students' health care training needs. Part VI, Line 6: Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance. 1 Dakota Heartland Development Association 601 N Main St Mitchell SD 57301 352397643 501(c)(3) 7500 0 Rural Economic Development 1 0 Scholarships 27 27000 Part I, Line 2: The organization provides grants/contributions to other organizations which are tax-exempt under IRS Section 501(c)(3) and governmental divisions that benefit the community and region through programs and activities. The scholarship recipients are determined through an application process with the Parkston Scholarship Fund, a program with the Parkston Area Foundation. All the money raised for the scholarship program is invested and managed through the Avera St. Benedict Foundation. The Parkston Scholarship Fund sends the list of scholarship winners to Avera St. Benedict and the checks are made out to the school with the student's name noted on the check. Any graduating senior from Parkston can apply for the scholarship, however, he or she must complete and pass 12 or more credit hours at a post-secondary institution in order to receive the funds. Some recipients are eligible for the fall semester following high school graduation because of dual credit courses; others become eligible by their spring semester. The Parkston Scholarship Fund requires the students to send their transcripts with proof of the 12 credits. 0 0 0 0 0 0 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0 1197590 0 480 0 5605 0 16500 0 2901 0 1223076 0 0 Jason Wickersham MD Family Practice/OB Physician 399955 0 61932 0 1214 0 16500 0 33660 0 513261 0 0 0 Paul Berndt MD Family Practice/OB Physician 314729 0 38750 0 58149 0 16500 0 40454 0 468582 0 0 0 Larissa Sanger MD Family Practice/OB Physician 297858 0 21187 0 379 0 12620 0 40394 0 372438 0 0 0 Antoinette VanderPol MD Chair/Family Medicine/OB 300331 0 10000 0 18051 0 16240 0 13645 0 358267 0 0 0 Jedd Bialas CRNA 233279 0 11500 0 185 0 12525 0 35429 0 292918 0 0 0 Beth Schroeder Manager - Clinic 161191 0 41305 0 887 0 7526 0 24554 0 235463 0 0 0 Lindsay Weber President/CEO 0 145229 0 0 0 114 0 3889 0 39355 0 188587 0 0 Schedule J, Part I, Line 3: The President/CEO is compensated by Avera Queen of Peace. St. Benedict Health Center relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. Form 990, Item J: The organization's website is: avera.org/locations/profile/avera-st-benedict-health-center/ Form 990, Part VI, Section A, line 2 Julie Lautt, Jason Wickersham, MD, and Sr. Pam Donelan have a business relationship. Julie Lautt and Lindsay Weber have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors. Form 990, Part VI, Section A, line 7b Avera Health, as the sole member, has the following rights as the Member. 1) Define the purpose, philosophy and mission of this Corporation. 2) Receive and approve budgets of this Corporation. 3) Review and approve audited financial reports of this Corporation. 4) Dissolve, merge or consolidate this Corporation. 5) Approve the selection and retention of the independent auditing firm. 6) Approve any action which would change the character of this Corporation. 7) Initiate and/or approve all amendments to the Articles of Incorporation and Bylaws of this Corporation. 8) Appoint and remove, with or without cause, the Directors, sanction vacancies and determine the number of Directors of this Corporation; 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member; 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member; 11) To establish and maintain employee benefit programs; 12) To establish and maintain insurance programs; 13) To approve major community fund drives; 14) To approve the appointment of auditors; 15) To adopt policies designed to effectuate the reserved powers of the Member. Form 990, Part VI, Section A, line 8b St. Benedict Hospital does not have any committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. Form 990, Part VI, Section B, line 15a The President and CEO of Avera Queen of Peace, a related organization, initiates the annual review for the CEO. He sends out evaluation forms to the board of St. Benedict's. Comparative data from Avera Health System is used to develop a recommended compensation structure. The analysis and recommendation is completed by a System compensation consultant who has access to multiple salary survey results and uses the predominant factors of FTE, revenue, and operating expenses to benchmark the position to similar healthcare organization data. The compensation for the CEO is approved by Avera St. Benedict's board. This is done on an annual basis, usually in January. The CFO-Avera Health is 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. Form 990, Part VI, Section C, line 19 The 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 IX, line 11g Purchased Services: Program service expenses 1,297,870. Management and general expenses 26,575. Fundraising expenses 0. Total expenses 1,324,445. Medical Professional Fees: Program service expenses 12,525. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,525. Repairs & Maintenance: Program service expenses 521,402. Management and general expenses 27,909. Fundraising expenses 0. Total expenses 549,311. Centralized Services: Program service expenses 622,948. Management and general expenses 1,241,629. Fundraising expenses 0. Total expenses 1,864,577. Form 990, Part XI, line 9: Change in Interest in Avera Foundation 214,603. Form 990, Part XII, Line 2c: The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the audited financial statements for Avera Health, which includes St. Benedict Health Center. Form 990, Part X, Line 20: St. Benedict Health Center is part of the Avera Obligated Group which 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. St. Benedict Health Center was not allocated any share of the bond issue, and thus does not have an amount on line 20. Avera Health 3900 West Avera Drive Suite 300 Sioux Falls SD 57108 460422673 Promotion of health SD 501(c)(3) Line 10 N/A 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera at Home 5300 S Broadband Lane Sioux Falls SD 57108 460399291 Home services SD 501(c)(3) Line 10 Avera Health 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing and health plan admin SD 501(c)(4) Avera Health 0 Avera Marshall 300 S Bruce ST Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 0 Avera Granite Falls 345 10th Ave Granite Falls MN 56241 843156881 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Queen of Peace Hospital 525 North Foster Street Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare services NE 501(c)(3) Line 3 Avera Health 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 0 Holy Family Hospital Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Lewis and Clark Health Education and Service Agency 1000 W 4th ST Suite 9 Yankton SD 57078 460337013 Healthcare services SD 501(c)(3) Line 10 Avera Health 0 Avera Home Medical Equipment of Floyd Valley Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 820582350 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Lakes Regional Healthcare LLC 5300 S Broadband Lane Sioux Falls SD 57108 862949748 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Sioux Center LLC 5300 S Broadband Lane Sioux Falls SD 57108 753203100 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Spencer Hospital LLC 5300 S Broadband Lane Sioux Falls SD 57108 800619999 Medical services - home medical equipment SD N/A 0 0 Brookings Health System - Avera HME LLC 300 22nd Ave Brookings SD 57006 453204123 Medical services - home medical equipment SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 611843657 Accountable Care Organization MO N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 821447782 Accountable Care Organization MO N/A 0 0 Heart Hospital of South Dakota LLC 4500 W 69th Street Sioux Falls SD 57108 562143771 Healthcare Services SD N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Pennsylvania St Aberdeen SD 57401 460461429 Surgical Associates SD N/A 0 0 Accounts Management Inc 5132 S Cliff Avenue Suite 101 Sioux Falls SD 57108 460373021 Collection Agency SD N/A C 0 Avera Property Insurance Inc 1000 West 4th Street Suite 1 Yankton SD 57078 460463155 Insurance SD N/A C 0 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Rental Real Estate SD N/A C 0 Alucent Biomedical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 South Dakota State Medical Holding Company 5300 South Broadband Lane Sioux Falls SD 57108 460401087 Insurance SD N/A C 0 DakotaCare Administrative Services Inc 5300 South Broadband Lane Sioux Falls SD 57108 460424322 Insurance SD N/A C 0 Alucent Australia Pty Ltd Level 10 30 Collings Street Melbourne VIC 3000 AS Biotech Research AS N/A 0 Kore Cares In Home Services LLC 5300 South Broadband Lane Sioux Falls SD 57108 882778902 In-home care services SD N/A S 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0