AVERA ST ANTHONYS HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- AVERA ST ANTHONYS HOSPITAL (EIN 47-0463911)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202131379349305233
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T13:19:44-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | 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 | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470463911 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera St Anthony's Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 4023365132 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687631569 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 4023365132 | PhoneNum |
| Signature | 2021-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2021-05-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Todd Consbruck | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687631569 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,599,316 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | See Schedule O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 284 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $149,580 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,055,291 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,518,798 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $39,509,607 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,480,021 | PYInvestmentIncomeAmt |
| CY Investment Income | $976,343 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$14,952 | PYOtherRevenueAmt |
| CY Other Revenue | -$634 | CYOtherRevenueAmt |
| PY Total Revenue | $43,133,447 | PYTotalRevenueAmt |
| CY Total Revenue | $43,540,607 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,621 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,002,687 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,698,154 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,323,732 | PYOtherExpensesAmt |
| CY Other Expenses | $19,921,313 | CYOtherExpensesAmt |
| PY Total Expenses | $37,330,040 | PYTotalExpensesAmt |
| CY Total Expenses | $37,623,967 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,803,407 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,916,640 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $68,496,816 | TotalAssetsBOYAmt |
| Total Assets EOY | $81,208,125 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,758,150 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,949,177 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $57,738,666 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $62,258,948 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,501,716 | ExpenseAmt |
| Grant | $4,500 | GrantAmt |
| Revenue | $39,510,828 | RevenueAmt |
| Desc | Avera St. Anthony's mission is to provide healthcare services to O'Neill, Nebraska residents and residents of the surrounding area. Avera St. Anthony is a 501(c)(3) organization affiliated with Avera Health. Avera St. Anthony consists of a 25-bed critical access hospital in O'Neill, Nebraska and 7 clinics. The program services offered include primary care, emergency, telemedicine, general surgery, orthopedic surgery, podiatry surgery, cardiac rehab, pain management, OB, chemotherapy, radiology, sleep lab, dialysis, speech therapy, physical therapy, occupational therapy and pharmacy. Avera St. Anthony provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera St. Anthony Hospital630 Acute patient discharges146 Newborn patient discharges88 Swing bed patient discharges28,630 Outpatient visits647 Swing-bed patient days242 Newborn patient days25,774 Clinic visitsAvera St. Anthony 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 $647,095.Avera St. Anthony 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. Anthony 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. Anthony engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. | Desc |
| Total Program Service Expenses | $31,501,716 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | 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 | 0 | 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 | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | 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 | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 284 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| 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 | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jamie Schaefer | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 41.30 | Yes (X) | $0 | $1,018,166 | $36,856 | ||
| Julie Lautt - Joined 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 40.70 | Yes (X) | $0 | $518,454 | $35,583 | ||
| Wendell Spencer | ||||||||
| CRNA | 40.00 | 0.00 | $352,299 | $0 | $46,995 | Yes (X) | ||
| Josh Becker | ||||||||
| CRNA | 40.00 | 0.00 | $338,048 | $0 | $46,995 | Yes (X) | ||
| Wayne ScheidemannMemberMed | ||||||||
| Staff Pres/Ortho Surg-Left 9/2019 | 1.00 | 40.00 | $0 | $355,555 | $22,894 | Yes (X) | ||
| Kevin Loecker | ||||||||
| CRNA | 40.00 | 0.00 | $248,702 | $0 | $41,894 | Yes (X) | ||
| Todd Consbruck | ||||||||
| President & CEO | 24.00 | 16.00 | Yes (X) | $0 | $208,207 | $31,400 | Yes (X) | |
| Cameron Everitt | ||||||||
| Director of PT | 40.00 | 0.00 | $163,915 | $0 | $22,169 | Yes (X) | ||
| Dean Benson | ||||||||
| Physician Assistant | 40.00 | 0.00 | $165,188 | $0 | $19,651 | Yes (X) | ||
| Joe Krotter | ||||||||
| Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Deb Kelly | ||||||||
| Vice-Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Sister Kathryn Burt OSB | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Sister Lynn Marie Welbig PBVM | ||||||||
| Member | 1.00 | 4.00 | $0 | $0 | $0 | Yes (X) | ||
| Merri Schneider | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Dick Grosch | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Paul Carlson | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Russ McIntosh | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Jack Hurley | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Kirk Cisler | ||||||||
| Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,268,152 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,100,382 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $304,437 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Sacred Heart | |||||
| 501 Summit St | Yankton | SD | 57078 | Management, Support, & Lab Services | $7,950,142 |
| Avera Health | |||||
| 3900 W Avera Drive Suite 300 | Sioux Falls | SD | 57108 | Shared Services | $4,153,658 |
| Docs Who Care | |||||
| 800 West Frontier Ln | Olathe | KS | 66061 | ER Coverage Services | $494,903 |
| Avera McKennan Hospital | |||||
| 1325 S Cliff Ave | Sioux Falls | SD | 57105 | Physician Services | $323,613 |
| AMN Healthcare Inc | |||||
| 12400 High Bluff Dr | San Diego | CA | 92130 | Contract Labor | $241,732 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $19,095 | RelatedOrganizationsAmt |
| Government Grants | $3,018,746 | GovernmentGrantsAmt |
| All Other Contributions | $17,450 | AllOtherContributionsAmt |
| Noncash Contributions | $12,135 | NoncashContributionsAmt |
| Total Contributions | $3,055,291 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 622110 | $37,323,841 | $37,323,841 |
| Pharmacy Revenue | 900099 | $1,857,090 | $1,857,090 |
| Clinic Revenue | 621110 | $186,864 | $186,864 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,812 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $141,812 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $39,509,607 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,160 | TotalRevenueColumnAmt |
| Exclusion | $42,160 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,700 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,555 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$1,855 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,855 | TotalRevenueColumnAmt |
| Exclusion | -$1,855 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $972,825 | SecuritiesAmt |
| Other | $512 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $39,154 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $972,825 | SecuritiesAmt |
| Other | -$38,642 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $934,183 | TotalRevenueColumnAmt |
| Exclusion | $934,183 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | AR Interest Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,221 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,221 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,221 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,540,607 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,510,828 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $974,488 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,500 | TotalAmt |
| Program Services | $4,500 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,104,630 | TotalAmt |
| Program Services | $12,254,341 | ProgramServicesAmt |
| Management And General | $850,289 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,866 | TotalAmt |
| Program Services | $467,870 | ProgramServicesAmt |
| Management And General | $37,996 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,193,255 | TotalAmt |
| Program Services | $2,847,371 | ProgramServicesAmt |
| Management And General | $345,884 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $894,403 | TotalAmt |
| Program Services | $835,844 | ProgramServicesAmt |
| Management And General | $58,559 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,058 | TotalAmt |
| Management And General | $2,058 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,683,825 | TotalAmt |
| Program Services | $6,635,892 | ProgramServicesAmt |
| Management And General | $4,047,933 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,947 | TotalAmt |
| Program Services | $937 | ProgramServicesAmt |
| Management And General | $1,010 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,174 | TotalAmt |
| Program Services | $185,464 | ProgramServicesAmt |
| Management And General | $185,710 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,565 | TotalAmt |
| Program Services | $67,109 | ProgramServicesAmt |
| Management And General | $153,456 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $511,539 | TotalAmt |
| Program Services | $413,830 | ProgramServicesAmt |
| Management And General | $97,709 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $319,294 | TotalAmt |
| Program Services | $310,508 | ProgramServicesAmt |
| Management And General | $8,786 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,973 | TotalAmt |
| Program Services | $23,056 | ProgramServicesAmt |
| Management And General | $1,917 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,893 | TotalAmt |
| Program Services | $238,620 | ProgramServicesAmt |
| Management And General | $52,273 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,090,463 | TotalAmt |
| Program Services | $1,864,210 | ProgramServicesAmt |
| Management And General | $226,253 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,321 | TotalAmt |
| Management And General | $29,321 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $5,317,284 | $5,310,843 | $6,441 |
| Equipment Lease/Rental | $12,725 | $7,896 | $4,829 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,252 | TotalAmt |
| Program Services | $33,425 | ProgramServicesAmt |
| Management And General | $11,827 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,623,967 | TotalAmt |
| Program Services | $31,501,716 | ProgramServicesAmt |
| Management And General | $6,122,251 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $856,950 | BOYAmt |
| EOY | $2,079,779 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,306,346 | BOYAmt |
| EOY | $3,291,897 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,260,806 | BOYAmt |
| EOY | $1,200,875 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,829 | BOYAmt |
| EOY | $85,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,110,179 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,250,497 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,525,231 | BOYAmt |
| EOY | $12,859,682 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,824,942 | BOYAmt |
| EOY | $621,475 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,626,712 | BOYAmt |
| EOY | $60,817,732 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $251,064 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,496,816 | BOYAmt |
| EOY | $81,208,125 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,684,664 | BOYAmt |
| EOY | $2,654,193 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,086,565 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,082,771 | BOYAmt |
| EOY | $7,370,319 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $990,715 | BOYAmt |
| EOY | $6,838,100 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,758,150 | BOYAmt |
| EOY | $18,949,177 | 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 | $57,628,766 | BOYAmt |
| EOY | $62,133,098 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,900 | BOYAmt |
| EOY | $125,850 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,738,666 | BOYAmt |
| EOY | $62,258,948 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,496,816 | BOYAmt |
| EOY | $81,208,125 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,916,640 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$926,190 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$470,168 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,058 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,058 | 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 | Avera St. Anthony's Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $745,022 | OtherCostOrOtherBasisAmt |
| Book Value | $745,022 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,169,518 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,592,215 | DepreciationAmt |
| Book Value | $8,577,303 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,788,193 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,835,403 | DepreciationAmt |
| Book Value | $2,952,790 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,407,446 | OtherCostOrOtherBasisAmt |
| Depreciation | $822,879 | DepreciationAmt |
| Book Value | $584,567 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,859,682 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Assets Limited to Use - Avera Pooled Investments | $59,674,496 | F |
| Investment in Foundation | $1,143,236 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $60,817,732 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Right of Use Operating Lease Obligation | $17,315 |
| Contract Liability - Medicare Advance Payments | $6,611,671 |
| Deferred Payroll Taxes | $209,114 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,838,100 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Foundation's endowment consists of a portion of their interest in the net assets of St. Anthony's Hospital Foundation. The St. Anthony's Hospital 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. |
| Part X, Line 2: | Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $320,436 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $320,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00850 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,538,504 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,364,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,173,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03120 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,858,940 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,364,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,494,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03970 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $347,620 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $304,343 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,284 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,284 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,178,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $451,042 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $727,485 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $64 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $64 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,533,495 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $494,319 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,039,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02760 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,392,435 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,859,181 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,533,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06730 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,149,400 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,353,747 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,615,427 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$261,680 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera St Anthony's Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68763 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Part V, Page 10 | WebsiteAddressTxt |
| State License | 410002 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Provider based clinics - 1 RHC & 6 physician clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony's Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See website address on 7d narrative | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See website address on 7d narrative | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See website address on Part V narrative. | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Anthony's Hospital | Part V, Section B, Line 5: Avera St. Anthony's Hospital initiated a community focus group meeting and also conducted personal interviews with electronic communication responses. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: * O'Neill Police Department (OPD)* O'Neill Public Schools (OPS)* North Central District Health Department (NCDHD)* Avera St. Anthony's Hospital Social Service Department* University of Nebraska Lincoln Extension* Central Nebraska Community Action Partnership* O'Neill Ministerial Association* United Methodist Church Food Pantry* Holt County Economic Development |
| St. Anthony's Hospital | Part V, Section B, Line 6a: Antelope Memorial HospitalAvera Creighton HospitalBrown County HospitalCHI Health Plainview HospitalOsmond General Hospital |
| St. Anthony's Hospital | Part V, Section B, Line 6b: North Central District Health Department Region 4 Behavioral Health SystemO'Neill Public School Rural Region One Medical Response System |
| St. Anthony's Hospital | Part V, Section B, Line 7d: Other website: www.avera.org/about/community-health-needs-assessments/ |
| St. Anthony's Hospital | Part V, Section B, Line 11: The community health needs assessment was completed in 2018. The following community health priority areas were identified. CHRONIC DISEASE DETECTION & MANAGEMENT-Explore feasibility of expanding Social Work support to incorporate a Cancer case management system, child abuse prevention strategies, domestic violence, and Hospice care.FY2020 Update: October 2019 - A PA-C transitioned to the Oncology service area, received training and provides case management to acute and ambulatory care services.FY2020 Update: Social Worker integrates services with Avera Coordinated Care, Dialysis and Home Health/Hospice. Referrals were initiated from the providers in January 2019 for short term counseling resulting in 47 referrals with current consultations of 18 people, some weekly, some every other week.In 2020 there were 30 referrals for short term counseling with integrated virtual options for counseling services.-Continue to promote health maintenance through health screenings and additional options of detection/care management (Blood Pressure checks, bone density, skin cancer screening).Health Fair April & OctoberFY2020 Update: October 2019 - The Fair was held on Oct 8th and 22nd. 581 lab panels, 145 PSA tests and 286 Hgb. A1Cs were completed.FY2020 Update: April 2020 With considerations given to COVID-19 restraints the 2020 Health Fairs were cancelled.Farm & Home Show February FY2020 Update: February 5 & 6 2020- Educational awareness of services in public transportation and Health Fair event utilizing brochures and radio broadcast interview.Community Food Pantry monthly/quarterlyFY2020 Update: No public interaction provided due to COVID-19 restraints.-Provide support to the community food pantry through financial contribution and physical presence to offer blood pressure screening, mental wellness screening tools, nutrition education.FY2020 Update: November 2019 - Financial support provided to United Methodist Church Community Food Pantry with intent to assist in the expense of food transport.-Promote dietary education internally and externally of the hospital through provision of calorie counts of food items and nutritional information tools. FY2020 Update: Met with Dietician discussed the following:-Childhood Obesity Prevention Program "Food, Fitness, Fun" for grades 1-6 1hr/day for 8 weeks.-Developing eagles-Summerfest-Food Pantry-KBRX Radio-NCCCP Grants-Food Pyramid purchaseFY2020 Update: Considerations given to COVID-19 restraints. This action step was not completed due to COVID 19 restraints of public interaction and compromised staffing issues. MENTAL WELLNESS-Provide support to the Befriend Family mentoring program through financial contribution to maintain coordination and viability of program. Provide program brochure to Medical Staff and clinic waiting areas.FY2020 Update: November 2019 Program promoted in Medical Staff and Ministerial Association meetings. Brochures made available in community churches and clinic waiting rooms. Hospital room space provided for organizational meetings. Support for viability and coordination continues.FY2020: May 2020 Program Coordinator hired for management of Befriend program. Financial donation submitted to organization to support expenses.-Partner with North Central District Health Department in suicide prevention initiative through sponsorship of public viewing of Suicide Prevention video "The Ripple Effect".FY2020 Update: November 25, 2019 40 people attended the event hosted at a community church and sponsored by the following: NCDHD, Region 4 Behavioral Health System, O'Neill Public Schools, Avera St. Anthony's Hospital, Faith Community Church, Norfolk Area Loss Team, and North Central Community Care Partnership. Behavioral Health professionals were available following viewing but no interest taken.-Implement Avera suicide staff education, precautions and screening policies in the ED and promote use of Avera Farmer's Stress Hotline resources.FY2020 Update: Brochures of Farmer Stress hotline were made available throughout hospital waiting area and promoted periodically on social media/radio stations. FY2020 Update: Interventions to predict the presence and severity of depression were completed within the Emergency Department. A screening policy performs the Suicide Risk Primary Screen that additionally addresses abuse and violence/trafficking. This screening then potentially leads to the Columbia Suicide Severity Rating Scale which allows for continued support and/or intervention.The following health needs/priorities will not be addressed due to either a relative low priority, resource constraints or, because other facilities or educational entities are addressing the issues:-Resources Across the Lifespan-Substance AbuseMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. |
| St. Anthony's Hospital | 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. Anthony's Hospital | 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 on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| St. Anthony's Hospital | 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. Anthony's Hospital | Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. |
| Part V, Lines 16a, 16b, and 16c: | https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. |
| Part I, Line 7: | Charity care and unreimbursed Medicaid were converted to cost using the cost-to-charge ratio derived from Worksheet 2. Subsidized health services were calculated using a combination of cost-to-charge ratio derived from Worksheet 2 and the Medicare cost report. Community health improvement services, health professions education and cash and inkind donations are actual expenses recorded in the general ledger. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 17 and 18. |
| Part III, Line 8: | St. Anthony's Hospital follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare 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. |
| Schedule H, Part V, Section A, Line 1 | https://www.avera.org/locations/profile/avera-st-anthonys-hospital/ |
| Part VI, Line 2: | Avera St. Anthony's Hospital conducts an annual strategic planning meeting that includes a cross section of community members. Our Hospital Board of Directors, Hospital Finance Committee, Foundation Board of Directors, Community Medical Staff, and Hospital Department Directors meet to assess community input from the local nursing facility, assisted living, and local public health office. Our Hospital and Foundation Boards and Finance Committee are made up of a majority of community members. This group drafts an annual strategic plan of goals, objectives, and strategies that are continuously updated to address the needs of the community. Additionally, input from the local ministerial association, law enforcement, Chamber of Commerce, elementary and secondary public and parochial schools, and the local community college are assessed and incorporated into the plan. Our CHNA report was completed during fiscal year ended June 30, 2019. |
| Part VI, Line 3: | Patients are informed of the financial assistance/charity care policy through brochures and posted policies at the registration desks of the Hospital and Emergency Department. Avera St. Anthony's has staff in central registration that identify if a patient has the financial means to pay for services or insurance to cover these services. Public assistance is also pursued if deemed appropriate. If patients are identified as candidates for charity care they are directed to our financial services representative and the application process is initiated for charity care. Patient financial services can assist with determining what benefits the patient may qualify for and assists with helping them apply for any benefits. If there is no option for an outside assistance program, the patient is informed and encouraged to complete the application that utilizes a combination of income, assets, and expenses to determine what percentage of charity care they would qualify for. |
| Part VI, Line 4: | Avera St Anthony's is a 25-bed hospital in O'Neill, Nebraska. The primary service area is defined as Holt County, Nebraska. O'Neill is the county seat. According to the U.S. Census Bureau Quick Facts 2019 data, the estimated population of Holt County as of July 1, 2019 is 10,067 and is predominately white at 97.2%. It is estimated that 22.0% of the population is 65 years and over. The median household income is $60,387 with an 11.1% poverty rate. Uninsured individuals under age 65 is estimated at 10.7%. |
| Part VI, Line 5: | The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. 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. |
| 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $945,274 | $0 | $1,760 | $0 | $71,132 | $0 | $14,000 | $0 | $22,856 | $0 | $1,055,022 | $0 | $0 |
| Julie Lautt - Joined 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $516,081 | $0 | $400 | $0 | $1,973 | $0 | $14,000 | $0 | $21,583 | $0 | $554,037 | $0 | $0 |
| Wendell Spencer | ||||||||||||||
| CRNA | $234,331 | $0 | $114,475 | $0 | $3,493 | $0 | $14,000 | $0 | $32,995 | $0 | $399,294 | $0 | $0 | $0 |
| Josh Becker | ||||||||||||||
| CRNA | $211,338 | $0 | $125,850 | $0 | $860 | $0 | $14,000 | $0 | $32,995 | $0 | $385,043 | $0 | $0 | $0 |
| Wayne ScheidemannMemberMed | ||||||||||||||
| Staff Pres/Ortho Surg-Left 9/2019 | $0 | $328,510 | $0 | $17,400 | $0 | $9,645 | $0 | $14,000 | $0 | $8,894 | $0 | $378,449 | $0 | $0 |
| Kevin Loecker | ||||||||||||||
| CRNA | $227,782 | $0 | $19,725 | $0 | $1,195 | $0 | $12,732 | $0 | $29,162 | $0 | $290,596 | $0 | $0 | $0 |
| Todd Consbruck | ||||||||||||||
| President & CEO | $0 | $207,174 | $0 | $0 | $0 | $1,033 | $0 | $10,717 | $0 | $20,683 | $0 | $239,607 | $0 | $0 |
| Cameron Everitt | ||||||||||||||
| Director of PT | $162,941 | $0 | $440 | $0 | $534 | $0 | $8,385 | $0 | $13,785 | $0 | $186,085 | $0 | $0 | $0 |
| Dean Benson | ||||||||||||||
| Physician Assistant | $164,455 | $0 | $0 | $0 | $733 | $0 | $8,349 | $0 | $11,301 | $0 | $184,838 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The President/CEO's compensation is paid by a related organization, Avera Sacred Heart. Avera St. Anthony's Hospital relied on the related organizations for determining the compensation for the President/CEO using the methods described in Part I, Line 3. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Avera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. |
| Form 990, Part VI, Section A, line 8b | Avera St. Anthony's Hospital does not have a committee with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is reviewed by the Avera Health VP of Financial Reporting, Tax Manager, Facility CEO and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. |
| Form 990, Part VI, Section B, line 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 | Compensation of the President and CEO is determined by Avera Sacred Heart Hospital, a related exempt organization. The Board of Directors reviews the management agreement with Avera Sacred Heart Hospital and discusses and approves the agreement. 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. Negotiations are done as needed. For other staff members, some of whom may serve on the board of directors, as officers, or as key employees, a salary review is done by a committee based on hospital association surveys, including hospital size. |
| 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 | Repairs and Maintenance: Program service expenses 822,430. Management and general expenses 17,830. Fundraising expenses 0. Total expenses 840,260. Medical Prof Fees: Program service expenses 669,268. Management and general expenses 0. Fundraising expenses 0. Total expenses 669,268. Purchased Services: Program service expenses 5,144,194. Management and general expenses 178,103. Fundraising expenses 0. Total expenses 5,322,297. Centralized Services: Program service expenses 0. Management and general expenses 3,852,000. Fundraising expenses 0. Total expenses 3,852,000. |
| Form 990, Part XI, line 9: | Equity Transfers -477,118. Change in Interest in Avera Foundation 6,950. |
| 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 Avera St. Anthony's Hospital. |
| Form 990, Part X, Line 20: | Avera St. Anthony's Hospital 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. Avera St. Anthony's Hospital was not allocated any share of the bond issue, and thus does not have an amount on line 20. |
| Form 990, Page 1, Item J Website: | avera.org/locations/profile/avera-st-anthonys-hospital/ |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 W Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| Avera Holy Family | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare services | IA | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Holy Family Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support health related services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family | |
| St Benedict Health Center | |||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| St Benedict Health Center Foundation | |||||||||||
| 401 West Glynn Drive PO Box B | Parkston | SD | 57366 | 460458725 | Support health related services | SD | 501(c)(3) | Line 12a, I | 0 | St Benedict Health Center | |
| Avera McKennan | |||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460224743 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera Queen of Peace Hospital | |||||||||||
| 525 North Foster | Mitchell | SD | 57301 | 420224604 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera at Home | |||||||||||
| 5116 S Solberg Ave | Sioux Falls | SD | 57108 | 460399291 | Home Services | SD | 501(c)(3) | Line 10 | 0 | Avera Health | |
| Lewis and Clark Health Ed and Serv Agency | |||||||||||
| 1000 W 4th Street Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare education | SD | 501(c)(3) | Line 10 | 0 | Sacred Heart Health Services | |
| Avera St Luke's | |||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Marshall | |||||||||||
| 300 S Bruce St | Marshall | MN | 56258 | 410919153 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Mary's | |||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Tyler | |||||||||||
| 240 Willow Street | Tyler | MN | 56178 | 410853163 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Health Plans Inc | |||||||||||
| 3900 W Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health financing and health plan admin | SD | 501(c)(4) | 0 | Avera Health | ||
| Avera Granite Falls | |||||||||||
| 345 10th Ave | Granite Falls | MN | 56241 | 843156881 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | |||||||
| 714 E Lincoln St NE | Lemars | IA | 51031 | 820582350 | Medical services - home medical equipment | SD | N/A |
| Avera Home Medical Equipment of Sioux Center LLC | |||||||
| 38 19th St SW | Sioux Center | IA | 51250 | 753203100 | Medical services - home medical equipment | SD | N/A |
| Avera Home Medical Equipment of Spencer Hospital LLC | |||||||
| 2400 S Minnesota Avenue 102 | Sioux Falls | SD | 57117 | 800619999 | Medical Services - home medical equipment | SD | N/A |
| Q&M Properties LLC | |||||||
| 525 North Foster | Mitchell | SD | 57301 | 730652049 | Medical clinic building | SD | N/A |
| Surgical Associates Endoscopy Clinic LLC | |||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | Surgical associates | SD | N/A |
| Heart Hospital of South Dakota LLC | |||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare Services | SD | N/A |
| Brookings Health System - Avera HME LLC | |||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A |
| National Rural ACO 4 LLC dba Prairie Hills Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 371780735 | Accountable Care Organization | KS | N/A |
| National Rural ACO 5 LLC dba Great Plains Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 383958290 | Accountable Care Organization | KS | N/A |
| Caravan Health ACO 41 LLC dba Prairie View Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 821447782 | Accountable Care Organization | KS | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | |||||||||
| 5132 S Cliff Avenue Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection Services | SD | N/A | C | 0 |
| Avera Property Insurance Inc | |||||||||
| 1000 West 4th Street Suite 1 | Yankton | SD | 57078 | 460463155 | Property 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 Medical Inc | |||||||||
| 31325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | Biotech Research | SD | N/A | C | 0 |
| South Dakota State Medical Holding Company Inc | |||||||||
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |