AVERA HEALTH: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: AVERA HEALTH (EIN 46-0422673)
Tax period: 2023-07-01 to 2024-06-30
Filed: 2025-05-14
IRS object ID: 202541349349308514
Schema version: 2023v6.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-05-14T14:15:01-05:00	ReturnTs
Tax Period End	2024-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Eide Bailly LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	800 Nicollet Mall Ste 1300	AddressLine1Txt
City	Minneapolis	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554027033	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460422673	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Julie Lautt	PersonNm
Person Title	CFO/Secretary	PersonTitleTxt
Phone	6053224700	PhoneNum
Signature	2025-05-12	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2025-05-12	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	James Dover FACHE	PrincipalOfficerNm

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$278,886,077	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.avera.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	2069	TotalEmployeeCnt
Total Volunteers	11	TotalVolunteersCnt
Total Gross UBI	$7,718,321	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$5,239,067	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$22,270,065	PYContributionsGrantsAmt
CY Contributions Grants	$13,740,538	CYContributionsGrantsAmt
PY Program Service Revenue	$250,557,105	PYProgramServiceRevenueAmt
CY Program Service Revenue	$249,827,079	CYProgramServiceRevenueAmt
PY Investment Income	$12,851,478	PYInvestmentIncomeAmt
CY Investment Income	$13,888,133	CYInvestmentIncomeAmt
PY Other Revenue	-$340,137	PYOtherRevenueAmt
CY Other Revenue	$968,330	CYOtherRevenueAmt
PY Total Revenue	$285,338,511	PYTotalRevenueAmt
CY Total Revenue	$278,424,080	CYTotalRevenueAmt
PY Grants And Similar Paid	$26,892,445	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$16,682,844	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$171,315,196	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$159,054,954	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$2,343,131	CYTotalFundraisingExpenseAmt
PY Other Expenses	$93,674,720	PYOtherExpensesAmt
CY Other Expenses	$104,648,744	CYOtherExpensesAmt
PY Total Expenses	$291,882,361	PYTotalExpensesAmt
CY Total Expenses	$280,386,542	CYTotalExpensesAmt
PY Revenues Less Expenses	-$6,543,850	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,962,462	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,738,162,649	TotalAssetsBOYAmt
Total Assets EOY	$2,306,128,147	TotalAssetsEOYAmt
Total Liabilities BOY	$1,435,789,048	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,968,523,287	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$302,373,601	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$337,604,860	NetAssetsOrFundBalancesEOYAmt
Mission	Avera Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$238,134,264	ExpenseAmt
Grant	$16,682,844	GrantAmt
Revenue	$249,827,079	RevenueAmt
Desc	Avera Health is a nonprofit corporation jointly sponsored by the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota and the Benedictine Convent of the Sacred Heart of Yankton, South Dakota, together referenced as the "Sisters." Avera Health acts as the leader of the Avera health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. These organizations provide services principally in eastern South Dakota and surrounding states. Avera Health provides management consulting, fund raising and other administrative services to the hospitals, long-term health care facilities, clinics, services and programs that are sponsored or otherwise affiliated with the Sisters.	Desc
Total Program Service Expenses	$238,134,264	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	Yes (1)	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	160	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	2069	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	AK	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	AL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	AR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CO	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CT	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	DC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	HI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	ME	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MD	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MO	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NJ	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NM	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	ND	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OK	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	RI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	SC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	TN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Jamie Schaefer	PersonNm
Phone	6053223992	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
James Dover
President/CEO (Eff 10/2023)	45.00	1.00	Yes (X)	Yes (X)	$396,393	$0	$3,389
Bob Sutton
President/CEO (End 08/2023)	45.00	1.00	Yes (X)	Yes (X)	$2,080,463	$0	$60,433
Dr Luis Rojas-Espaillat
Chair, Gynecologic Oncology	5.00	40.00	Yes (X)	Yes (X)	$0	$697,255	$53,521
Lori Essig
Vice Chair	5.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
Sister Candyce Chrystal
Board Member	5.00	3.00	Yes (X)		$0	$0	$0
Sister Pam Donelan
Board Member	5.00	2.00	Yes (X)		$0	$0	$0
Robert Fouberg
Board Member	5.00	0.00	Yes (X)		$0	$0	$0
Doneen Hollingsworth
Board Member	5.00	0.00	Yes (X)		$0	$0	$0
Sister Mary Jaeger
Board Member	5.00	0.00	Yes (X)		$0	$0	$0
Dr Wayne Kindle
Board Member	5.00	0.00	Yes (X)		$0	$0	$0
Sister Debra Kolecka
Board Member	5.00	4.00	Yes (X)		$0	$0	$0
Sister Mary Kay Panowicz
Board Member	5.00	1.00	Yes (X)		$0	$0	$0
Sister Roxanne Seifert
Board Member	5.00	2.00	Yes (X)		$0	$0	$0
Clark Sinclair
Board Member	5.00	0.00	Yes (X)		$0	$0	$0
Dr Katherine Wang
Board Member, Neonatology	5.00	40.00	Yes (X)		$0	$507,178	$17,435
Dr Jason Wickersham
Board Member, Family Medicine/OBGYN	5.00	40.00	Yes (X)		$0	$463,101	$50,160
Julie Lautt
CFO, Treasurer	45.00	1.40		Yes (X)	$1,203,675	$0	$19,401
Richard Korman
Chief Legal Officer, Secretary	40.00	0.00		Yes (X)	$808,575	$0	$50,377
Daniel Bjerknes
President/CEO, St. Luke's	0.00	40.00			$503,084	$0	$50,471	Yes (X)
Doug Ekeren
President/CEO, Sacred Heart	0.00	41.00			$652,618	$0	$50,377	Yes (X)
David Flicek
Chief Operating Officer	40.00	0.00			$1,371,591	$0	$45,097	Yes (X)
Shantel Krebs
President/CEO, St. Mary's	0.00	42.00			$83,231	$186,423	$18,256	Yes (X)
Dr Ronald Place
President/CEO, McKennan	0.00	40.00			$726,858	$0	$17,030	Yes (X)
Dr Hillary Rockwell
President/CEO, Queen of Peace	0.00	40.00			$245,314	$221,675	$57,403	Yes (X)
Debbie Streier
President/CEO, Marshall	0.00	44.50			$489,400	$0	$17,435	Yes (X)
Shandon Hatch
Radiology	0.00	40.00			$656,579	$0	$57,402		Yes (X)
Bruk Kammerman
Sr. VP - Chief Information	40.00	0.00			$696,536	$0	$17,939		Yes (X)
Kevin Post
Chief Medical Officer	40.00	0.00			$800,524	$0	$60,452		Yes (X)
Casey Swenson
Radiology	0.00	40.00			$733,755	$0	$57,633		Yes (X)
Kimberly Jensen
Chief Human Resources Officer	40.00	0.00			$650,782	$0	$43,547		Yes (X)
Thomas Clark Former
Chief Strategy & Growth Officer	40.00	1.00			$1,666,396	$0	$25,250			Yes (X)
David Erickson
Former Chief Medical Officer	0.00	0.00			$630,520	$0	$16,500			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$14,396,294	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,075,632	TotReportableCompRltdOrgAmt
Total Other Compensation	$789,508	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	252	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CDW LLC
230 N Milwaukee Ave	Vernon Hills	IL	60061	Software; Hardware; Services	$17,263,547
Medical Information Technology Inc
7 Blue Hill River Rd	Canton	MA	02021	Software; Services	$6,235,476
MedSpeed
140 Industrial Drive	Elmhurst	IL	60126	Courier Services	$5,017,560
Microsoft Corporation
1950 N Stemmons Fwy Ste 5010	Dallas	TX	75207	Software; Services	$4,939,072
Mediability Inc
4742 42nd Ave SW 323	Seattle	WA	98116	Marketing Services	$4,357,381

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	95	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$285,822	FederatedCampaignsAmt
Fundraising	$738,655	FundraisingAmt
Related Organizations	$101,872	RelatedOrganizationsAmt
Government Grants	$1,952,594	GovernmentGrantsAmt
All Other Contributions	$10,661,595	AllOtherContributionsAmt
Noncash Contributions	$116,509	NoncashContributionsAmt
Total Contributions	$13,740,538	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
ACS revenue	900099	$213,910,172	$213,910,172
Other revenue	900099	$24,611,663	$23,787,970	$823,693
PACE revenue	561000	$7,005,261	$88,567	$6,916,694
Premier expense credits	900099	$4,299,983	$4,299,983

Field	Value	IRS element (for citing)
Total Program Service Revenue	$249,827,079	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,863,007	TotalRevenueColumnAmt
Exclusion	$11,863,007	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$179,197	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$161,338	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$17,859	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,859	TotalRevenueColumnAmt
Unrelated Business Revenue	-$22,066	UnrelatedBusinessRevenueAmt
Exclusion	$39,925	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,116,502	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$91,376	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,116,502	SecuritiesAmt
Other	-$91,376	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,025,126	TotalRevenueColumnAmt
Exclusion	$2,025,126	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$1,159,754	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$738,655	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$209,283	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$950,471	TotalRevenueColumnAmt
Exclusion	$950,471	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$278,424,080	TotalRevenueColumnAmt
Related Or Exempt Func Income	$242,086,692	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,718,321	UnrelatedBusinessRevenueAmt
Exclusion	$14,878,529	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$16,586,102	TotalAmt
Program Services	$16,586,102	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$96,742	TotalAmt
Program Services	$96,742	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$10,093,148	TotalAmt
Management And General	$10,093,148	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$278,417	TotalAmt
Program Services	$278,417	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$133,747,476	TotalAmt
Program Services	$112,727,408	ProgramServicesAmt
Management And General	$19,652,762	ManagementAndGeneralAmt
Fundraising	$1,367,306	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,510,072	TotalAmt
Program Services	$5,199,171	ProgramServicesAmt
Management And General	$249,535	ManagementAndGeneralAmt
Fundraising	$61,366	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	-$333,220	TotalAmt
Program Services	-$2,975,958	ProgramServicesAmt
Management And General	$2,432,345	ManagementAndGeneralAmt
Fundraising	$210,393	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$9,759,061	TotalAmt
Program Services	$8,888,063	ProgramServicesAmt
Management And General	$774,051	ManagementAndGeneralAmt
Fundraising	$96,947	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$398,512	TotalAmt
Program Services	$94,034	ProgramServicesAmt
Management And General	$304,478	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,544,794	TotalAmt
Program Services	$1,503,794	ProgramServicesAmt
Management And General	$41,000	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$154,266	TotalAmt
Program Services	$154,266	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$18,191,793	TotalAmt
Program Services	$15,744,602	ProgramServicesAmt
Management And General	$2,311,435	ManagementAndGeneralAmt
Fundraising	$135,756	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,993,999	TotalAmt
Program Services	$7,859,069	ProgramServicesAmt
Management And General	$24,040	ManagementAndGeneralAmt
Fundraising	$110,890	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,443,362	TotalAmt
Program Services	$7,338,504	ProgramServicesAmt
Management And General	$43,244	ManagementAndGeneralAmt
Fundraising	$61,614	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$39,259,015	TotalAmt
Program Services	$38,418,550	ProgramServicesAmt
Management And General	$576,291	ManagementAndGeneralAmt
Fundraising	$264,174	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,690,428	TotalAmt
Program Services	$1,430,945	ProgramServicesAmt
Management And General	$3,259,483	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,010,991	TotalAmt
Program Services	$806,178	ProgramServicesAmt
Management And General	$183,537	ManagementAndGeneralAmt
Fundraising	$21,276	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$811,379	TotalAmt
Program Services	$720,169	ProgramServicesAmt
Management And General	$87,107	ManagementAndGeneralAmt
Fundraising	$4,103	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$634,536	TotalAmt
Program Services	$526,585	ProgramServicesAmt
Management And General	$107,951	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$22,247,685	TotalAmt
Program Services	$21,056,924	ProgramServicesAmt
Management And General	$1,187,885	ManagementAndGeneralAmt
Fundraising	$2,876	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	-$3,638,478	TotalAmt
Program Services	-$2,195,706	ProgramServicesAmt
Management And General	-$1,442,772	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
UBI tax	$2,758,317	$2,758,317
Medical supplies	$972,556	$932,578	$37,837	$2,141
Equip Lease/Rental	$98,923	$88,314	$9,996	$613
Bad debt expense	$85,385	$85,385

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$8,719	TotalAmt
Program Services	$11,811	ProgramServicesAmt
Management And General	-$24,206	ManagementAndGeneralAmt
Fundraising	$3,676	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$280,386,542	TotalAmt
Program Services	$238,134,264	ProgramServicesAmt
Management And General	$39,909,147	ManagementAndGeneralAmt
Fundraising	$2,343,131	FundraisingAmt

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$39,556,446	BOYAmt
EOY	$185,193,801	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,454,625	BOYAmt
EOY	$1,414,472	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$27,678,643	BOYAmt
EOY	$28,855,505	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$2,288	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$9,452,715	BOYAmt
EOY	$7,943,618	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$15,507,258	BOYAmt
EOY	$27,068,144	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$268,420,736	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$170,652,334	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$93,208,062	BOYAmt
EOY	$97,768,402	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,261,490,473	BOYAmt
EOY	$1,667,210,051	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$150,197,416	BOYAmt
EOY	$136,750,549	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$18,492	BOYAmt
EOY	$41,565	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,197,241	BOYAmt
EOY	$16,197,241	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$123,401,278	BOYAmt
EOY	$137,682,511	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,738,162,649	BOYAmt
EOY	$2,306,128,147	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$26,358,847	BOYAmt
EOY	$36,735,756	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$11,588,034	BOYAmt
EOY	$5,077,859	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$15,361,822	BOYAmt
EOY	$36,331,786	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$1,035,287,668	BOYAmt
EOY	$1,433,900,514	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$19,295,412	BOYAmt
EOY	$18,589,482	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$327,897,265	BOYAmt
EOY	$437,887,890	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,435,789,048	BOYAmt
EOY	$1,968,523,287	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$286,933,501	BOYAmt
EOY	$320,611,813	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$15,440,100	BOYAmt
EOY	$16,993,047	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$302,373,601	BOYAmt
EOY	$337,604,860	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,738,162,649	BOYAmt
EOY	$2,306,128,147	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,962,462	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$32,247,346	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$4,946,375	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$23,574,843	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$21,836,149	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$40,871,703	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$22,270,065	CurrentTaxYearMinus1YearAmt
Current Tax Year	$13,740,538	CurrentTaxYearAmt
Total	$122,293,298	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$266,987,769	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$278,210,607	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$277,318,143	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$249,787,142	CurrentTaxYearMinus1YearAmt
Current Tax Year	$252,265,042	CurrentTaxYearAmt
Total	$1,324,568,703	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$290,562,612	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$300,046,756	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$318,189,846	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$272,057,207	CurrentTaxYearMinus1YearAmt
Current Tax Year	$266,005,580	CurrentTaxYearAmt
Total	$1,446,862,001	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$368,889	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$446,030	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$157,537	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$58,522	CurrentTaxYearMinus1YearAmt
Current Tax Year	$158,013	CurrentTaxYearAmt
Total	$1,188,991	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$178,295,346	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$177,531,681	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$212,485,978	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$194,153,214	CurrentTaxYearMinus1YearAmt
Current Tax Year	$177,815,503	CurrentTaxYearAmt
Total	$940,281,722	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$178,664,235	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$177,977,711	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$212,643,515	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$194,211,736	CurrentTaxYearMinus1YearAmt
Current Tax Year	$177,973,516	CurrentTaxYearAmt
Total	$941,470,713	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$505,391,288	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$22,385	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$199,301	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,830,463	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,609,325	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,863,854	CurrentTaxYearAmt
Total	$6,525,328	TotalAmt

Post1975 UBTI Post1975UBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,094,391	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,515,692	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,884,876	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,736,624	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,138,863	CurrentTaxYearAmt
Total	$16,370,446	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,116,776	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,714,993	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,715,339	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,345,949	CurrentTaxYearMinus1YearAmt
Current Tax Year	$6,002,717	CurrentTaxYearAmt
Total	$22,895,774	TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$369,995	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$197,164	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$243,606	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$540,124	CurrentTaxYearMinus1YearAmt
Current Tax Year	$950,471	CurrentTaxYearAmt
Total	$2,301,360	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$292,049,383	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$302,958,913	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$323,148,791	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$280,943,280	CurrentTaxYearMinus1YearAmt
Current Tax Year	$272,958,768	CurrentTaxYearAmt
Total	$1,472,059,135	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.34330	PublicSupportCY509Pct
Public Support PY509	0.35480	PublicSupportPY509Pct
Investment Income CY	0.01560	InvestmentIncomeCYPct
Investment Income PY	0.01290	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$2,389	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$151,877	OtherActivitiesAmt
Total Lobbying Expenditures	$154,266	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	Through paid staff and paid consultants Avera Health meets with legislators. Avera Health provides grants to other organizations for lobbying and pays dues of which a small portion is attributable to lobbying.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$19,295,442	BeginningYearBalanceAmt
Contributions	$1,301,057	ContributionsAmt
Investment Earnings Or Losses	-$1,419,368	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,062,186	OtherExpendituresAmt
Administrative Expenses	$58,770	AdministrativeExpensesAmt
End Year Balance	$18,056,175	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,349,540	BeginningYearBalanceAmt
Contributions	$829,430	ContributionsAmt
Investment Earnings Or Losses	$141,193	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,977,165	OtherExpendituresAmt
Administrative Expenses	$47,556	AdministrativeExpensesAmt
End Year Balance	$19,295,442	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,798,048	BeginningYearBalanceAmt
Contributions	$12,909,313	ContributionsAmt
Investment Earnings Or Losses	$136,229	InvestmentEarningsOrLossesAmt
Other Expenditures	$450,181	OtherExpendituresAmt
Administrative Expenses	$43,869	AdministrativeExpensesAmt
End Year Balance	$20,349,540	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

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

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.15520	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.06310	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.78170	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$32,005,994	OtherCostOrOtherBasisAmt
Depreciation	$13,783,076	DepreciationAmt
Book Value	$18,222,918	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,297,610	OtherCostOrOtherBasisAmt
Depreciation	$2,079,292	DepreciationAmt
Book Value	$2,218,318	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$216,271,808	OtherCostOrOtherBasisAmt
Depreciation	$154,789,966	DepreciationAmt
Book Value	$61,481,842	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,896,724	OtherCostOrOtherBasisAmt
Book Value	$14,896,724	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$97,768,402	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Interest in Innovation Institute	$10,201,824	F
Non-publicly traded hedge, private equity, debt, and multi-strategy funds	$114,717,069	F
Non-publicly traded real estate	$11,731,656	F
NPPC, LLC	$100,000	C

Field	Value	IRS element (for citing)
Total Book Value Securities	$136,750,549	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
Deferred financing costs	$13,084,609
Interest in South Dakota Community Foundation	$1,277,324
Deferred compensation	$116,427,304
Right of use operating lease	$3,984,107
Cash surrender value of life insurance policies	$2,909,167

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$137,682,511	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Estimated insurance claims payable	$27,775,266
Bond interest payable	$9,383,754
Due to affiliated entities	$175,925,833
Deferred compensation	$211,284,478
Long-term commitments	$9,182,919
Right of use lease obligations	$4,118,906
Other liabilities	$216,734

Field	Value	IRS element (for citing)
Total Liability	$437,887,890	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements.
Part V, Line 4:	The Organization's endowment consists of funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations.
Part X, Line 2:	Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean -	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$114,717,000	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$114,717,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$114,717,000	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (1)	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule F, Part I line 3(f)

Due to software limitations, the amount on line 3(f) is not printing correctly. The amount is $114,717,000.

Form 990, Schedule F, Part IV:

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

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Avera Race Against Cancer	Event1Nm
Gross Receipts Event1	$808,601	GrossReceiptsEvent1Amt
Charitable Contri Event1	$499,204	CharitableContriEvent1Amt
Gross Revenue Event1	$309,397	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$918	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$40,519	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$3,764	FoodAndBeverageEvent1Amt
Entertainment Event1	$18,765	EntertainmentEvent1Amt
Other Direct Expenses Event1	$5,130	OtherDirectExpensesEvent1Amt
Event2	Hearts in Healing	Event2Nm
Gross Receipts Event2	$240,912	GrossReceiptsEvent2Amt
Charitable Contri Event2	$180,092	CharitableContriEvent2Amt
Gross Revenue Event2	$60,820	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$6,518	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$7,654	FoodAndBeverageEvent2Amt
Entertainment Event2	$6,600	EntertainmentEvent2Amt
Other Events Total	18	OtherEventsTotalCnt
Gross Receipts Other Events	$832,420	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$47,352	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$785,068	GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events	$1,812	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$94,783	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$22,820	EntertainmentOtherEventsAmt
Gross Receipts Total	$1,881,933	GrossReceiptsTotalAmt
Charitable Contributions Tot	$726,648	CharitableContributionsTotAmt
Gross Revenue Total Events	$1,155,285	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$918	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$48,849	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$106,201	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$48,185	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$5,130	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$209,283	DirectExpenseSummaryEventsAmt
Net Income Summary	$946,002	NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (116 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
Abbott House Foundation
PO Box 700	Mitchell	SD	573010700	460379896	501c3	$42,500	$0	Donation
Aberdeen Catholic School Sys Inc
1400 N Dakota St	Aberdeen	SD	57401	460336005	501c3	$11,700	$0	Scholarship
Aberdeen Christian School
1500 Hwy 281 N	Aberdeen	SD	57401	911806433	501c3	$8,000	$0	Donation
Aberdeen Development Corporation
506 S Main St Ste 2	Aberdeen	SD	57401	466011831	501c6	$10,000	$0	Community Development
City of Aberdeen
123 S Lincoln St	Aberdeen	SD	574014215	466000010	City of Aberdeen	$25,000	$0	Donation
Aberdeen Family YMCA
5 S State St	Aberdeen	SD	57401	460255779	501c3	$25,500	$0	Donation
Aberdeen Ride Line
205 N 4th St	Aberdeen	SD	57401	466000010	501c3	$20,000	$0	Donation
Active Generations
2300 W 46th St	Sioux Falls	SD	57105	460305500	501c3	$12,500	$0	Donation
ALS Assoc MN ND SD Chapter
1919 University Ave West Ste 175	St Paul	MN	55104	411756085	501c3	$7,500	$0	Donation
Alzheimers Association South Dakota
4304 S Technology Dr	Sioux Falls	SD	57106	320151779	501c3	$10,000	$0	Donation
American Cancer Society
250 Williams St Nw Ste 400	Atlanta	GA	303031002	131788491	501c3	$15,000	$0	Donation
American Red Cross
431 18th St NW	Washington	DC	20006	530196605	501c3	$10,000	$0	Donation
The Banquet
900 E 8th St	Sioux Falls	SD	57103	460387495	501c3	$10,945	$0	Donation
Sioux Falls Catholic School Corporation
3100 W 41st St	Sioux Falls	SD	57105	460413591	501c3	$850,000	$0	Donation
Boy Scouts of America Sioux Council
801 N West Ave	Sioux Falls	SD	57104	460224599	501c3	$6,000	$0	Donation
Boys & Girls Club of Aberdeen Area
1111 SE 1st Ave	Aberdeen	SD	57401	237062273	501c3	$9,000	$0	Donation
Boys & Girls Club of Capital Area
2001 Eastgate Ave	Pierre	SD	57501	460305571	501c3	$10,000	$0	Donation
Boys & Girls Clubs of Sioux Empire
100 S Spring Ave Ste 280	Sioux Falls	SD	57104	460399482	501c3	$15,000	$0	Donation
Brookings School District 5-1
2130 8th St S	Brookings	SD	57006	466000834	School District	$41,700	$0	Donation
Call To Freedom Inc
1915 E 8th St Ste 100	Sioux Falls	SD	57103	475469817	501c3	$27,000	$0	Donation
Capital Area United Way
PO Box 1111	Pierre	SD	575011111	460403398	501c3	$5,740	$0	Donation
Career & Technical Education Academy
201 E 38th St	Sioux Falls	SD	57105	466002586	School District	$10,000	$0	Donation
Catholic Chancery Office
523 N Duluth Ave	Sioux Falls	SD	571042714	466000424	501c3	$110,000	$0	Donation
Central Lyon Community School
1010 S Greene St	Rock Rapids	IA	51246	426037624	School District	$15,000	$0	Donation
Childrens Home Society
801 N Sycamore Ave	Sioux Falls	SD	57110	460224542	501c3	$12,000	$0	Donation
City of Yankton
Box 176	Yankton	SD	57078	466000567	City of Yankton	$170,586	$0	Donation
Compass Center
1704 S Cleveland Ave Ste 3	Sioux Falls	SD	57103	460350199	501c3	$10,000	$0	Donation
Dakota Counseling institute
910 W Havens Ave	Mitchell	SD	573013831	460308930	501c3	$50,000	$0	Donation
Dakota Resources
25795 475th Ave Ste 1	Renner	SD	57055	460442430	501c3	$25,000	$0	Donation
Dakota Wesleyan University
1200 W University Ave	Mitchell	SD	57301	460224589	501c3	$6,000	$0	Scholarship
Dakotabilities Inc
1116 S 4th Ave	Sioux Falls	SD	57105	460306216	501c3	$20,000	$0	Donation
Delta Dental of SD Foundation
804 N Euclid Ste 101	Pierre	SD	57501	911776857	501c3	$24,000	$0	Donation
Downtown Sioux Falls Inc
315 N Phillips Ave Ste 200	Sioux Falls	SD	57104	363627217	501c4	$10,000	$0	Community Development
EmBe
300 W 11th St	Sioux Falls	SD	571046306	460234998	501c3	$45,000	$0	Donation
Emily's Hope Inc
221 S Phillips Ave Ste 203	Sioux Falls	SD	57104	833324332	501c3	$10,000	$0	Donation
Face It Together Inc
5020 S Tennis Ln Ste 4	Sioux Falls	SD	57108	272501220	501c3	$15,000	$0	Donation
Feeding South Dakota
4701 N Westport Ave	Sioux Falls	SD	571070123	363293534	501c3	$63,000	$0	Donation
Fellowship of Christian Athletes
1601 E 69th St Ste 301	Sioux Falls	SD	57108	440610626	501c3	$16,000	$0	Donation
Flandreau School District 50-3
600 W Community Dr	Flandreau	SD	57028	466002593	School District	$15,000	$0	Donation
Forward Sioux Falls
200 N Phillips Ave Ste 200	Sioux Falls	SD	571046058	460396647		$730,713	$0	Community Development
Furniture Mission of South Dakota
209 N Nesmith Ave	Sioux Falls	SD	57103	810584500	501c3	$17,500	$0	Donation
Girl Scouts-Dakota Horizons
1101 S Marion Rd	Sioux Falls	SD	571063466	460250744	501c3	$6,000	$0	Donation
GL Management LLC
3800 W 53rd St	Sioux Falls	SD	57106	463797566		$32,000	$0	Community Development
Governor's Office of Economic Development
711 E Well Ave	Pierre	SD	57501	466000364	State of SD	$51,500	$0	Community Development
Greater Sioux Falls Chamber of Commerce
200 N Phillips Ave Ste 200	Sioux Falls	SD	571046058	460189300	501c6	$17,750	$0	Community Development
Ground Works
102 N Krohns Pl Ste 113	Sioux Falls	SD	57103	475498537	501c3	$8,000	$0	Donation
Helpline Center Inc
3817 S Elmwood Ave	Sioux Falls	SD	57105	237424387	501c3	$54,500	$0	Donation
Junior Achievement of South Dakota
300 S Phillips Ave Ste L102	Sioux Falls	SD	57104	460306352	501c3	$25,800	$0	Donation
Kids' Chance of South Dakota
300 S Main Ave	Sioux Falls	SD	571046367	474439997	501c3	$8,000	$0	Scholarship
Leukemia & Lymphoma Society Inc
3 International Dr Ste	Rye Brook	NY	10573	135644916	501c3	$15,000	$0	Donation
Friends of Levitt Shell Sioux Falls
400 N Main Ave Suite 202	Sioux Falls	SD	57104	611699910	501c3	$30,000	$0	Donation
LIFE Runners
909 N Adams St 460651	Papillion	NE	68046	611672563	501c3	$12,500	$0	Donation
LifeScape Foundation
2501 W 26th St	Sioux Falls	SD	57105	460353254	501c3	$15,000	$0	Donation
Lost & Found
5015 S Crossing Pl 110	Sioux Falls	SD	57108	454306370	501c3	$10,000	$0	Donation
Lutheran Social Services of South Dakota
705 E 41St St Ste 200	Sioux Falls	SD	571056048	460224731	501c3	$10,000	$0	Donation
Make-A-Wish Foundation of SD
1400 W 17th St	Sioux Falls	SD	57104	460375953	501c3	$12,500	$0	Donation
Marshall Area YMCA
200 S A St	Marshall	MN	56258	411984589	501c3	$8,430	$0	Donation
Marshall Community Foundation
PO Box 11	Marshall	MN	56258	411555592	501c3	$50,000	$0	Donation
McCrossan Boys Ranch
47135 260th St	Sioux Falls	SD	571076428	460311913	501c3	$11,000	$0	Donation
Mitchell Area Development Corporation
601 N Main St	Mitchell	SD	57301	460394983	501c3	$192,155	$0	Donation
Mitchell Area Safehouse Inc
1809 N Wisconsin St	Mitchell	SD	57301	460389086	501c3	$70,000	$0	Donation
Mitchell School District 17-2
821 N Capital St	Mitchell	SD	57301	466001338	School District	$9,700	$0	Donation
Mitchell Technical Institute Foundation
1800 E Spruce St	Mitchell	SD	57301	460452950	501c3	$68,000	$0	Donation
Mitchell United Way
417 N Main St Ste 103	Mitchell	SD	573010729	461250302	501c3	$8,036	$0	Donation
Mount Marty University
1105 W 8th St	Yankton	SD	57078	460283336	501c3	$92,000	$0	Scholarship
NAMI of South Dakota
1601 E 69th St Ste 210	Sioux Falls	SD	57108	363593027	501c3	$32,000	$0	Donation
National Kidney Foundation
30 E 33rd St Ste 100	New York	NY	10016	131673104	501c3	$15,500	$0	Donation
National Multiple Sclerosis Society
733 Third Ave Flr 3	New York	NY	10017	135661935	501c3	$12,000	$0	Donation
Northern State University Foundation
620 15th Ave SE	Aberdeen	SD	57401	237002314	501c3	$1,400,000	$0	Donation
Pathways Shelter for the Homeless
412 E 4th St	Yankton	SD	57078	473974624	501c3	$26,000	$0	Donation
Pierre Area Referral Service
110 W Missouri Ave	Pierre	SD	57501	460317107	501c3	$20,000	$0	Donation
Presentation Sisters
1500 N 2nd St	Aberdeen	SD	57401	460253283	501c3	$6,775	$0	Donation
Pride In The Tiger Foundation
400 Tiger Dr	Marshall	MN	56258	411948007	501c3	$30,000	$0	Donation
Project CAR
2425 S Western Ave	Sioux Falls	SD	57105	460358227	501c3	$15,000	$0	Donation
River Cities Public Transit
1600 E Dakota Ave	Pierre	SD	57501	460449059	501c3	$25,000	$0	Donation
River City Domestic Violence Center
PO Box 626	Yankton	SD	57078	431992651	501c3	$60,000	$0	Donation
Ronald McDonald House Charities
825 S Lake Ave	Sioux Falls	SD	57104	460371152	501c3	$30,000	$0	Donation
Safe Harbor
PO Box 41	Aberdeen	SD	57401	460344310	501c3	$10,000	$0	Donation
Sculpture Walk Inc
300 S Phillips Ave Ste 104	Sioux Falls	SD	571046323	208535871	501c3	$21,500	$0	Donation
SD Youth Foundation Inc
1310 Main Ave S Ste 109	Brookings	SD	57006	474832848	501c3	$10,000	$0	Donation
SDSU Foundation
PO Box 525	Brookings	SD	57006	460273801	501c3	$25,000	$0	Donation
Sioux Empire Baseball Assoc Inc
1321 N Cleveland Ave	Sioux Falls	SD	571036111	411903475	501c3	$24,000	$0	Donation
Sioux Empire Fastpitch Softball Association
605 S Watson Ave Ste 100	Sioux Falls	SD	57108	237223489	501c3	$8,000	$0	Donation
Sioux Empire United Way
1000 N West Ave 120	Sioux Falls	SD	571041332	460233701	501c3	$113,581	$0	Donation
Sioux Falls Area CASA Program
100 S Spring Ave Ste 140	Sioux Falls	SD	57104	460430647	501c3	$10,000	$0	Donation
YMCA of Sioux Falls
220 S Minnesota	Sioux Falls	SD	57104	460225021	501c3	$10,000	$0	Donation
Sioux Falls School District
201 E 38th St	Sioux Falls	SD	57105	466002586	School District	$110,100	$0	Donation
Sioux Falls Public Schools Education Foundation
PO Box 560	Sioux Falls	SD	57101	263537657	501c3	$14,000	$0	Donation
SME Inc
PO Box 90310	Sioux Falls	SD	571090310	466012934	501c6	$6,200	$0	Donation
South Dakota Agricultural and Rural
Box 2170 Animal Science Ctr 132	Brookings	SD	57007	364293293	501c3	$10,000	$0	Donation
South Dakota Chanmber of Commerce & Industry
222 E Capital Ave Ste 17	Pierre	SD	575012564	460141180	501c6	$7,500	$0	Community Development
South Dakota State Medical Assoc
2600 W 49th St	Sioux Falls	SD	57105	460213945	501c6	$21,000	$0	Donation
South Dakota State University
Multiple Locations	Brookings	SD	57006	466000364	State of SD	$165,000	$0	Donation
South Dakota Symphony
301 S Main Ave 4th Flr	Sioux Falls	SD	57104	466017026	501c3	$40,000	$0	Donation
Southeast Technical College
2320 N Career Ave	Sioux Falls	SD	571071302	460214496	State of SD	$155,029	$0	Donation
Southwest Minnesota State University
1501 State St	Marshall	MN	56258	411687554	State of MN	$60,000	$0	Scholarship
Special Olympics South Dakota
800 E I90 Ln	Sioux Falls	SD	57104	460359776	501c3	$11,000	$0	Donation
Teddy Bear Den
500 S Main Ave	Sioux Falls	SD	57104	311802800	501c3	$15,000	$0	Donation
United Way of NE SD Foundation
PO Box 1065	Aberdeen	SD	57401	421568636	501c3	$17,670	$0	Donation
United Way of Southwest Minnesota
PO Box 41	Marshall	MN	562580041	416023143	501c3	$5,740	$0	Donation
United Way & Volunteer Services of Greater Yankton
610 W 3rd St Suite 11	Yankton	SD	57078	460252854	501c3	$12,607	$0	Donation
University of MN Foundation Medical School Duluth Campus
1035 University Dr	Duluth	MN	55812	416042488	501c3	$24,000	$0	Scholarship
University of Sioux Falls
1101 W 22nd St	Sioux Falls	SD	57105	460224600	501c3	$330,000	$0	Donation
University of South Dakota
414 E Clark St	Vermillion	SD	57069	466000364	State of SD	$473,000	$0	Scholarship
USD Foundation
1100 N Dakota	Vermillion	SD	57069	466018891	501c3	$20,000	$0	Scholarship
USD Gear Center
414 E Clark St	Vermillion	SD	57069	466000364	State of SD	$6,300	$0	Donation
Veterans Community Project
8900 Troost Ave	Kansas City	MO	64131	474960735	501c3	$30,000	$0	Donation
Volunteers of America Dakotas
PO Box 89306	Sioux Falls	SD	57109	237353508	501c3	$41,000	$0	Donation
Washington Pavilion Management Inc
PO Box 984	Sioux Falls	SD	571010984	460435791	501c3	$80,286	$0	Donation
Yankton Thrive Inc
803 E 4th St	Yankton	SD	57078	460348636	501c3	$60,000	$0	Donation
Yankton Parks & Rec
PO Box 176	Yankton	SD	57078	466000567	City of Yankon	$10,000	$0	Donation
Yankton School District 63-3
2410 W City Limits Rd	Yankton	SD	57078	466003280	School District	$10,000	$0	Donation
University of South Dakota Research Park
4800 N Career Ave Suite 100	Sioux Falls	SD	57107	462693612	501c3	$50,580	$0	Donation
South Dakota Community Foundation
Po Box 296	Pierre	SD	57501	460398115	501c3	$200,493	$0	Donation
Teammates Mentoring Program
121 S 13th St	Lincoln	NE	68508	470840990	501c3	$93,352	$0	Donation
University of South Dakota - South Dakota HOSA Future Health Professionals
4801 N Career Ave	Sioux Falls	SD	571071329	466000364	State of SD	$30,000	$0	Donation

Field	Value	IRS element (for citing)
Total501c3 Org	118	Total501c3OrgCnt
Total Other Org	8	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Medical assistance to employees	23	$42,242
Medical educational scholarships	10	$10,000
Pastoral educational scholarships	17	$44,500

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The Organization makes grants to other organizations exempt under 501(c)(3) to ensure the funds will be used for charitable purposes. During the year ending June 30, 2024, the Organization made contributions to other non-public charities and other organizations in furtherance of community development. The contributions are approved by the Board for this purpose. Scholarship funds have different sets of criteria for determining eligibility and winners. Assistance to individuals is determined with assistance from each hospital's social services department or within a committee at the hospital.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Bob Sutton
President/CEO (End 08/2023)	$2,068,183	$0	$0	$0	$12,280	$0	$16,500	$0	$43,933	$0	$2,140,896	$0	$0	$0
Thomas Clark Former
Chief Strategy & Growth Officer	$6,334	$0	$0	$0	$1,660,062	$0	$16,500	$0	$8,750	$0	$1,691,646	$0	$0	$0
David Flicek
Chief Operating Officer	$1,327,499	$0	$700	$0	$43,392	$0	$16,500	$0	$28,597	$0	$1,416,688	$0	$0	$0
Julie Lautt
CFO, Treasurer	$1,197,590	$0	$480	$0	$5,605	$0	$16,500	$0	$2,901	$0	$1,223,076	$0	$0	$0
Kevin Post
Chief Medical Officer	$797,551	$0	$270	$0	$2,703	$0	$16,500	$0	$43,952	$0	$860,976	$0	$0	$0
Richard Korman
Chief Legal Officer, Secretary	$798,056	$0	$0	$0	$10,519	$0	$16,500	$0	$33,877	$0	$858,952	$0	$0	$0
Casey Swenson
Radiology	$596,763	$0	$105,739	$0	$31,253	$0	$16,500	$0	$41,133	$0	$791,388	$0	$0	$0
Dr Luis Rojas-Espaillat
Chair, Gynecologic Oncology	$0	$661,963	$0	$24,000	$0	$11,292	$0	$24,960	$0	$28,561	$0	$750,776	$0	$0
Dr Ronald Place
President/CEO, McKennan	$676,736	$0	$30,000	$0	$20,122	$0	$16,500	$0	$530	$0	$743,888	$0	$0	$0
Bruk Kammerman
Sr. VP - Chief Information	$693,883	$0	$0	$0	$2,653	$0	$16,500	$0	$1,439	$0	$714,475	$0	$0	$0
Shandon Hatch
Radiology	$561,502	$0	$56,608	$0	$38,469	$0	$16,500	$0	$40,902	$0	$713,981	$0	$0	$0
Doug Ekeren
President/CEO, Sacred Heart	$641,698	$0	$900	$0	$10,020	$0	$16,500	$0	$33,877	$0	$702,995	$0	$0	$0
Kimberly Jensen
Chief Human Resources Officer	$636,041	$0	$650	$0	$14,091	$0	$16,500	$0	$27,047	$0	$694,329	$0	$0	$0
David Erickson
Former Chief Medical Officer	$17,614	$0	$0	$0	$612,906	$0	$16,500	$0	$0	$0	$647,020	$0	$0	$0
Daniel Bjerknes
President/CEO, St. Luke's	$498,188	$0	$0	$0	$4,896	$0	$16,500	$0	$33,971	$0	$553,555	$0	$0	$0
Dr Katherine Wang
Board Member, Neonatology	$0	$414,028	$0	$91,886	$0	$1,264	$0	$16,500	$0	$935	$0	$524,613	$0	$0
Dr Hillary Rockwell
President/CEO, Queen of Peace	$237,154	$213,545	$7,500	$7,500	$660	$630	$5,507	$10,993	$20,449	$20,454	$271,270	$253,122	$0	$0
Dr Jason Wickersham
Board Member, Family Medicine/OBGYN	$0	$399,955	$0	$61,932	$0	$1,214	$0	$16,500	$0	$33,660	$0	$513,261	$0	$0
Debbie Streier
President/CEO, Marshall	$481,234	$0	$440	$0	$7,726	$0	$16,500	$0	$935	$0	$506,835	$0	$0	$0
James Dover
President/CEO (Eff 10/2023)	$388,194	$0	$0	$0	$8,199	$0	$0	$0	$3,389	$0	$399,782	$0	$0	$0
Shantel Krebs
President/CEO, St. Mary's	$79,808	$173,373	$0	$4,000	$3,423	$9,050	$8,869	$8,869	$259	$259	$92,359	$195,551	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 4a	Thomas Clark received severance pay of $1,660,062. David Erickson received severance pay of $612,906.
Part I, Line 7	During the current year, the organization paid bonuses for longevity, Great Expectation incentive program, and employee referral program bonus. Some individuals received incentives related to retention and loan forgiveness. Physicians receive incentives based on production.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VUS1	2012-05-01	$206,383,927	Series 2012B refunded 2002 and 2008A bonds issued 4/11/02 and 6/18/08	0	0	0
South Dakota Health and Educational Facilities Authority
B	460315509	83755VG99	2017-10-11	$242,848,916	Series 2017 refunded bond issued 6/18/08;const/equip healthcare facilities	0	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	83755VU44	2024-04-24	$114,418,553	See Supplemental Detail	0	0	0
South Dakota Health and Educational Facilities Authority
D	460315509	83755VU44	2024-04-24	$251,862,322	Construction/equipment healthcare facilities	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	UnspentUnspentAmt
A	$108,668,927	$206,383,927	$1,032,422	$38,100,000	$167,251,505	2013	Yes (1)	0	Yes (1)	Yes (1)
B	$23,293,916	$242,848,916	$1,786,422	$190,000,000	$51,062,494		0	Yes (1)	Yes (1)	Yes (1)
C		$114,418,553	$742,310		$113,676,243		Yes (1)	Yes (1)	Yes (1)	Yes (1)
D		$251,862,322	$1,633,842	$42,346,205			0	0	0	Yes (1)	$207,882,275

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line (f) Description of purpose, Bond C:	FormAndLineReferenceDesc
Explanation	Refund Series 2014 Bonds issued 6/26/2014, Series 2019A Bonds issued 11/13/2019, and2017 taxable loan obtained 6/28/2017.	ExplanationTxt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
Debbie Streier
Key Employee	Student Loan	Yes (X)	$13,187	$1,272	0	Yes (1)	Yes (1)
Debbie Streier
Key Employee	Retention Loan	Yes (X)	$10,000	$1,016	0	Yes (1)	Yes (1)

Field	Value	IRS element (for citing)
Total Balance Due	$2,288	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Katherine Schild
Family member of Key Employee, Doug Ekeren	$102,824	Compensation and benefits as an employee	0
Grant Flicek
Family member of Key Employee, David Flicek	$170,744	Compensation and benefits as an employee	0

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$62,526	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Selling Price	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	Items for Patients	3	$23,174	Cost
Yes (X)	Auction Items	11	$14,665	FMV
Yes (X)	Lights, Light Poles, and installation	1	$13,000	Cost
Yes (X)	Chairs	1	$3,144	FMV

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

Supplemental Information Detail SupplementalInformationDetail (2 entries)

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 2	Julie Lautt, Dr. Luis Rojas-Espaillat, Dr. Katherine Wang, and Dr. Jason Wickersham have a business relationship.
Form 990, Part VI, Section A, line 6	Avera Health has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of up to nine members (i) three Presentation Sisters or their designees appointed by the Presentation Sponsorship Members; (ii) three Benedictine Sisters or their designees appointed by the Benedictine Sponsorship Members; and (iii) up to three additional members appointed by the Sponsorship Members. At no time shall the number of designees be greater than the total number of Benedictine and Presentation Sisters.
Form 990, Part VI, Section A, line 7a	The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint a Benedictine Sister, Presentation Sister, or a Ministerial Juridic Person to the Boards of Directors of any sponsored work or ministry of Avera Health.
Form 990, Part VI, Section A, line 7b	The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint a Presentation Sister, a Benedictine Sister, or a Ministerial Juridic Person to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the Avera Health President; (e) To review and approve expenditures outside of the annual operating and capital budgets, for Avera Health in accordance with established Avera Health fiscal policies; (f) To review and approve the Avera Health Strategic Plan; (g) To review and approve any and all Rescript Applications on behalf of Avera Health; (h) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (i) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (j) To adopt policies designed to effectuate the powers reserved to the System Members; and (k) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members.
Form 990, Part VI, Section A, line 8b	Avera Health does not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11b	The Form 990 is 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 and other Operation Finance Leaders. The public disclosure copy is made available to 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 15	Annually the Compensation Committee of Avera Health, which is comprised of six (6) system members appointed by the religious orders, meets with an independent consultant regarding fair market value for compensation of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.
Form 990, Part VI, Section C, line 19	The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public.
Form 990, Part VI, Section B, Line 16b:	There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.
Form 990, Part X, Line 20:	The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg and Avera at Home. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).
Form 990, Part XI, line 9:	Net equity transfers -25,210,550. Other changes in net assets -1,994,572. Net assets released from restriction -494,949. Adjustments to the funded status of pension plans 43,614,103. Non Operating Other -9,540,393. Reclassification of prior year donation expense 500,000. Contributions received by Avera Health Foundation not reflected in financial statements -10,596,831. Grants to organizations distributed by Avera Health Foundation not reflected in financial statements 8,669,567.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera at Home
5300 S Broadband Lane	Sioux Falls	SD	57108	460399291	Home services	SD	501(c)(3)	Line 10	Avera Health	Yes (1)
Avera Health Plans Inc
3900 West Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health financing & health plan admin	SD	501(c)(4)		Avera Health	Yes (1)
Avera Marshall
300 S Bruce Street	Marshall	MN	56258	410919153	Healthcare services	MN	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Granite Falls
345 10th Ave	Granite Falls	MN	56241	843156881	Healthcare services	MN	501(c)(3)	Line 3	Avera Marshall	0
Avera Tyler
240 Willow Street	Tyler	MN	56178	410853163	Healthcare services	MN	501(c)(3)	Line 3	Avera Marshall	Yes (1)
Avera Queen of Peace Hospital
525 North Foster	Mitchell	SD	57301	460224604	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare services	NE	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare services	SD	501(c)(3)	Line 3	Avera St Mary's	Yes (1)
Avera Holy Family
826 North 8th Street	Estherville	IA	51334	420680370	Healthcare services	IA	501(c)(3)	Line 3	Avera Health	Yes (1)
Holy Family Hospital Foundation
826 North 8th Street	Estherville	IA	51334	421317452	Support health related services	IA	501(c)(3)	Line 10	Avera Holy Family	Yes (1)
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9	Yankton	SD	57078	460337013	Healthcare services	SD	501(c)(3)	Line 10	Avera Health	Yes (1)
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
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	Healthcare Services	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 Penn	Aberdeen	SD	57401	460461429	Surgical associates	SD	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Direct Controlling NADirectControllingNACd
Accounts Management Inc
5132 S Cliff Ave Suite 101	Sioux Falls	SD	57108	460373021	Collection Agency	SD	Avera Health	C	$4,674,347	$3,287,985	1.00000	Yes (1)
Alucent Australia Pty Ltd
					Biotech Research		Alucent Biomedical Inc		$531,683	$247,493	0.70200	Yes (1)	Level 10 30 Collings Street	Melbourne	VIC 3000	AS	AS
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	Biotech Research	SD	Alumend LLC	C	-$8,327,603	$7,027,725	0.70200	Yes (1)
Avera Property Insurance Inc
1000 West 4th Street Suite 1	Yankton	SD	57078	460463155	Insurance	SD	Avera Health	C	-$245,714	$1,948,671	1.00000	Yes (1)
DakotaCare Administrative Services Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460424322	Insurance	SD	Avera Health	C	$200,847	$366,501	1.00000	Yes (1)
South Dakota State Medical Holding Company Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460401087	Insurance	SD	Avera Health	C	$147,561	$2,547,471	1.00000	Yes (1)
Valley Health Services
501 Summit Street	Yankton	SD	57078	460357149	Rental Real Estate	SD	Sacred Heart Health Services	C	$46,648	$1,012,788	1.00000	Yes (1)
Kore Cares In Home Services LLC
5300 South Broadband Lane	Sioux Falls	SD	57108	882778902	In-Home Care Services	SD		S				0						N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (47 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera McKennan
K	$184,011	Vendor Payment Listing
Avera Health Plans Inc
K	$252,880	Vendor Payment Listing
Avera Holy Family
L	$2,648,605	General Ledger
Avera St Luke's
L	$17,760,642	General Ledger
Avera Sacred Heart Health Services
L	$11,659,269	General Ledger
Avera Marshall
L	$12,729,977	General Ledger
Avera Queen Of Peace Hospital
L	$10,240,273	General Ledger
Avera St Mary's
L	$9,626,428	General Ledger
Avera At Home
L	$4,840,739	General Ledger
Avera Health Plans Inc
L	$2,292,700	General Ledger
St Benedict Health Center
L	$1,923,057	General Ledger
Accounts Management Inc
L	$480,804	General Ledger
South Dakota State Medical Holding Company Inc
L	$56,260	General Ledger
Avera McKennan
L	$130,663,431	General Ledger
Avera St Anthony's Hospital
L	$3,594,155	General Ledger
Avera At Home
O	$222,130	General Ledger
Avera St Mary's
O	$1,390,247	General Ledger
Avera McKennan
O	$5,829,969	General Ledger
Avera St Anthony's Hospital
O	$69,426	General Ledger
Avera Sacred Heart Health Services
O	$1,183,111	General Ledger
Avera St Luke's
O	$2,666,855	General Ledger
Avera Health Plans Inc
O	$1,055,703	General Ledger
Avera Marshall
O	$189,504	General Ledger
Avera Queen Of Peace Hospital
O	$1,389,902	General Ledger
St Benedict Health Center
O	$51,484	General Ledger
Avera Marshall
P	$58,565	Vendor Payment Listing
Avera McKennan
P	$5,853,626	Vendor Payment Listing
Avera Health Plans Inc
P	$12,044,123	Vendor Payment Listing
Avera St Luke's
P	$56,131	Vendor Payment Listing
Avera St Luke's
Q	$6,865,759	Customer Invoice Listing
Avera St Mary's
Q	$3,714,138	Customer Invoice Listing
Avera Sacred Heart Health Services
Q	$4,666,606	Customer Invoice Listing
Avera Queen Of Peace Hospital
Q	$4,433,490	Customer Invoice Listing
Avera Marshall
Q	$2,613,308	Customer Invoice Listing
St Benedict Health Center
Q	$382,987	Customer Invoice Listing
Avera St Anthony's Hospital
Q	$1,025,944	Customer Invoice Listing
Avera At Home
Q	$713,696	Customer Invoice Listing
Avera Holy Family
Q	$594,722	Customer Invoice Listing
Avera McKennan
Q	$91,572,374	Customer Invoice Listing
Accounts Management Inc
Q	$186,389	Customer Invoice Listing
Avera Health Plans Inc
Q	$68,075	Customer Invoice Listing
Avera Sacred Heart Health Services
R	$512,361	General Ledger
Avera McKennan
R	$3,078,531	General Ledger
Avera St Mary's
R	$151,897	General Ledger
Avera Marshall
R	$302,169	General Ledger
Avera St Luke's
R	$192,405	General Ledger
Avera Queen Of Peace Hospital
R	$314,154	General Ledger