AVERA QUEEN OF PEACE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- AVERA QUEEN OF PEACE (EIN 46-0224604)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201901349349307990
- Schema version
- 2017v2.3
- 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 | 2019-05-14T15:30:13-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | 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 | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460224604 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 6059952251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jim Breckenridge | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 6059952251 | PhoneNum |
| Signature | 2019-05-13 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2019-05-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 8.39.233.107 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-13 | IPDt |
| IP Tm | 13:39:10 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace Health Service | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Thomas A Clark | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $117,098,604 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.averaqueenofpeace.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 933 | TotalEmployeeCnt |
| Total Volunteers | 52 | TotalVolunteersCnt |
| Total Gross UBI | $149,898 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$30,786 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,615,911 | PYContributionsGrantsAmt |
| CY Contributions Grants | $564,767 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $109,423,369 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $109,555,717 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,084,587 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,657,795 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$75,121 | PYOtherRevenueAmt |
| CY Other Revenue | -$16,527 | CYOtherRevenueAmt |
| PY Total Revenue | $115,048,746 | PYTotalRevenueAmt |
| CY Total Revenue | $112,761,752 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $783,630 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,899 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $61,070,062 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $60,605,431 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $127,074 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,178,487 | PYOtherExpensesAmt |
| CY Other Expenses | $48,599,268 | CYOtherExpensesAmt |
| PY Total Expenses | $110,032,179 | PYTotalExpensesAmt |
| CY Total Expenses | $109,215,598 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,016,567 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,546,154 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $139,884,199 | TotalAssetsBOYAmt |
| Total Assets EOY | $140,736,352 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $45,757,451 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,955,295 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $94,126,748 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $97,781,057 | 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 | $93,064,209 | ExpenseAmt |
| Grant | $10,899 | GrantAmt |
| Revenue | $109,600,714 | RevenueAmt |
| Desc | Avera Queen of Peace's mission is to provide healthcare services to Mitchell, South Dakota residents and residents of the surrounding area. Avera Queen of Peace is a 501(c)(3) organization affiliated with Avera Health. Avera Queen of Peace consists of a 67-bed hospital and an 84-bed nursing home in Mitchell, SD, a 16-bed critical access hospital in Wessington Springs, SD, a 6-bed critical access hospital in De Smet, SD and 13 physician clinics. The physician clinics include primary care, ob/gyn, pediatrics, orthopedics, general surgery, internal medicine, radiation, radiology, oncology, dermatology, therapy, ophthalmology and optometry. They provide acute care and long-term healthcare services, of which there were 1,973 patient discharges, 141,357 outpatient visits, 1,322 swing-bed patient days, 1,148 nursery patient days, 28,684 nursing home resident days, 8,547 assisted living resident days, 2,067 independent living days, and 74,176 clinic visits. Following is a breakdown of these statistics by facility:Avera Queen of Peace Hospital1,869 Acute patient discharges125,985 Outpatient visits902 Swing-bed patient days1,148 Newborn patient days74,176 Clinic visitsAvera Brady Health and Rehabilitation28,684 Long-term care resident days8,547 Assisted living patient days2,067 Independent living daysAvera Westkota Memorial Medical Center (CAH)66 Acute patient discharges4,297 Outpatient visits227 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH)38 Acute patient discharges11,075 Outpatient visits193 Swing-bed patient daysAvera Queen of Peace 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 $3,745,457.Avera Queen of Peace 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 Queen of Peace 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 or persons and institutions. Avera Queen of Peace 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 | $93,064,209 | 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 137 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 933 | 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 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| 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 (25 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Diane Sandhoff | ||||||||
| Chairperson | 2.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jean Koehler | ||||||||
| Vice Chair | 2.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jason Bradley | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Julie Brookbank | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Quinten Burg | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Kathleen Crowley | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Bonita Gacnik | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Ryan Huber | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Brian Kampmann MD | ||||||||
| Board Member (thru Jan 2018) | 40.00 | 0.00 | Yes (X) | $1,274,161 | $0 | $42,493 | ||
| Sharry Knock | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Michael Krause DO | ||||||||
| Board Member | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| David Olson | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Hillary Rockwell MD | ||||||||
| Board Member/Physician | 40.00 | 0.00 | Yes (X) | $457,021 | $0 | $42,256 | ||
| Jay Tolsma | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jerry Thomsen | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gopal Vyas | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Aaron BaasBoard | ||||||||
| Member/Physician (as of Feb 2018) | 40.00 | 0.50 | Yes (X) | $640,413 | $0 | $42,493 | ||
| Thomas Clark | ||||||||
| President & CEO | 40.00 | 0.50 | Yes (X) | Yes (X) | $0 | $499,210 | $40,774 | |
| Jim Breckenridge | ||||||||
| CFO Avera Health | 0.10 | 39.90 | Yes (X) | $0 | $887,406 | $34,116 | ||
| William E Flett | ||||||||
| Secretary | 40.00 | 1.00 | Yes (X) | $69,327 | $124,723 | $36,536 | ||
| Chris Krouse DO | ||||||||
| Orthopedics, Sports Medici | 40.00 | 0.00 | $1,410,952 | $0 | $37,003 | Yes (X) | ||
| Kathleen Naegele DO | ||||||||
| Hematology and Oncology | 40.00 | 0.00 | $622,932 | $0 | $38,156 | Yes (X) | ||
| Xenofon Papadopoulos MD | ||||||||
| Urology | 40.00 | 0.00 | $593,805 | $0 | $42,493 | Yes (X) | ||
| Dennis Leland | ||||||||
| General Surgery | 40.00 | 0.00 | $547,529 | $0 | $38,247 | Yes (X) | ||
| Darren Manthey | ||||||||
| Emergency Physician | 40.00 | 0.00 | $536,613 | $0 | $37,237 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,152,753 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,511,339 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $431,804 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 60 | 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 Health | |||||
| 3900 W Avera Dr | Sioux Falls | SD | 57108 | Shared Services, ACS Fees, eCare, and Co | $13,130,953 |
| Avera McKennan | |||||
| PO Box 86370 | Sioux Falls | SD | 571186370 | Fees,Locums, Services, and Labor | $1,338,074 |
| Journey Group Companies | |||||
| 4500 W 58th St | Sioux Falls | SD | 57108 | Construction | $964,213 |
| Horizon Health Care Inc | |||||
| 109 N Main PO Box 99 | Howard | SD | 57349 | Locums and Purchased Clinic Services | $279,051 |
| Icon Medical Network LLC | |||||
| 8100 SW Nyberg St Ste 400 | Tualatin | OR | 97062 | Hospitalist Medical Locum Services | $217,368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $339,400 | RelatedOrganizationsAmt |
| Government Grants | $163,098 | GovernmentGrantsAmt |
| All Other Contributions | $62,269 | AllOtherContributionsAmt |
| Total Contributions | $564,767 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient & Resident Services | 622110 | $106,854,784 | $106,854,784 | |
| Cafeteria | 900099 | $413,456 | $413,456 | |
| Retail Pharmacy | 900099 | $149,898 | $149,898 | |
| Meaningful Use Revenue | 900099 | $11,002 | $11,002 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,126,577 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,126,577 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $109,555,717 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,671 | TotalRevenueColumnAmt |
| Exclusion | $69,671 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $396,292 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $457,816 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$61,524 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$61,524 | TotalRevenueColumnAmt |
| Exclusion | -$61,524 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,463,060 | SecuritiesAmt |
| Other | $4,100 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,721,938 | SecuritiesAmt |
| Other | $157,098 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,741,122 | SecuritiesAmt |
| Other | -$152,998 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,588,124 | TotalRevenueColumnAmt |
| Exclusion | $2,588,124 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Operating Interest | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $44,997 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,997 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $44,997 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $112,761,752 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,450,816 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $149,898 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,596,271 | 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 | $10,899 | TotalAmt |
| Program Services | $10,899 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,835,566 | TotalAmt |
| Program Services | $2,835,566 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,032,739 | TotalAmt |
| Program Services | $41,279,673 | ProgramServicesAmt |
| Management And General | $3,685,684 | ManagementAndGeneralAmt |
| Fundraising | $67,382 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,368,235 | TotalAmt |
| Program Services | $3,100,231 | ProgramServicesAmt |
| Management And General | $263,230 | ManagementAndGeneralAmt |
| Fundraising | $4,774 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,551,449 | TotalAmt |
| Program Services | $6,031,298 | ProgramServicesAmt |
| Management And General | $510,886 | ManagementAndGeneralAmt |
| Fundraising | $9,265 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,817,442 | TotalAmt |
| Program Services | $2,595,991 | ProgramServicesAmt |
| Management And General | $217,507 | ManagementAndGeneralAmt |
| Fundraising | $3,944 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,225 | TotalAmt |
| Management And General | $4,225 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,193 | TotalAmt |
| Management And General | $10,193 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,014,720 | TotalAmt |
| Program Services | $4,265,827 | ProgramServicesAmt |
| Management And General | $8,748,893 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,562 | TotalAmt |
| Program Services | $12,947 | ProgramServicesAmt |
| Management And General | $6,540 | ManagementAndGeneralAmt |
| Fundraising | $75 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,168,973 | TotalAmt |
| Program Services | $5,498,742 | ProgramServicesAmt |
| Management And General | $1,636,380 | ManagementAndGeneralAmt |
| Fundraising | $33,851 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,353 | TotalAmt |
| Program Services | $335,702 | ProgramServicesAmt |
| Management And General | $113,651 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,020,126 | TotalAmt |
| Program Services | $1,453,133 | ProgramServicesAmt |
| Management And General | $566,463 | ManagementAndGeneralAmt |
| Fundraising | $530 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,415 | TotalAmt |
| Program Services | $352,601 | ProgramServicesAmt |
| Management And General | $74,864 | ManagementAndGeneralAmt |
| Fundraising | $2,950 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,012 | TotalAmt |
| Program Services | $65,226 | ProgramServicesAmt |
| Management And General | $43,126 | ManagementAndGeneralAmt |
| Fundraising | $3,660 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,348,569 | TotalAmt |
| Program Services | $1,348,569 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,154,348 | TotalAmt |
| Program Services | $5,154,348 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $864,210 | TotalAmt |
| Program Services | $861,100 | ProgramServicesAmt |
| Management And General | $3,110 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $12,761,878 | $12,761,878 | |
| Bad Debt Expense | $3,400,706 | $3,400,706 | |
| Repairs and Maintenance | $1,451,243 | $1,425,442 | $25,801 |
| Taxes and Licenses | $7,270 | $7,270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,465 | TotalAmt |
| Program Services | $267,060 | ProgramServicesAmt |
| Management And General | $113,762 | ManagementAndGeneralAmt |
| Fundraising | $643 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,215,598 | TotalAmt |
| Program Services | $93,064,209 | ProgramServicesAmt |
| Management And General | $16,024,315 | ManagementAndGeneralAmt |
| Fundraising | $127,074 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,772,161 | BOYAmt |
| EOY | $4,207,368 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,309,834 | BOYAmt |
| EOY | $11,286,034 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,392 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,542,276 | BOYAmt |
| EOY | $1,715,262 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,038,197 | BOYAmt |
| EOY | $637,928 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $127,300,088 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $70,893,458 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,380,130 | BOYAmt |
| EOY | $56,406,630 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,813,173 | BOYAmt |
| EOY | $63,966,250 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,211,114 | BOYAmt |
| EOY | $988,660 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,496,395 | BOYAmt |
| EOY | $1,451,150 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,527 | BOYAmt |
| EOY | $77,070 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,884,199 | BOYAmt |
| EOY | $140,736,352 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,753,712 | BOYAmt |
| EOY | $7,874,888 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,444,913 | BOYAmt |
| EOY | $33,900,473 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,426 | BOYAmt |
| EOY | $7,469 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,552,400 | BOYAmt |
| EOY | $1,172,465 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,757,451 | BOYAmt |
| EOY | $42,955,295 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,168,813 | BOYAmt |
| EOY | $94,691,411 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,146,910 | BOYAmt |
| EOY | $2,278,250 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $811,025 | BOYAmt |
| EOY | $811,396 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,126,748 | BOYAmt |
| EOY | $97,781,057 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,884,199 | BOYAmt |
| EOY | $140,736,352 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,546,154 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $642,182 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$534,027 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $10,193 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,193 | 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 Queen of Peace Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities. | 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 | $2,748,708 | BeginningYearBalanceAmt |
| Contributions | $424 | ContributionsAmt |
| Investment Earnings Or Losses | $37,389 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,077,965 | OtherExpendituresAmt |
| End Year Balance | $708,556 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,715,895 | BeginningYearBalanceAmt |
| Contributions | $256,959 | ContributionsAmt |
| Investment Earnings Or Losses | $252,847 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $463,879 | OtherExpendituresAmt |
| Administrative Expenses | $13,114 | AdministrativeExpensesAmt |
| End Year Balance | $2,748,708 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,859,724 | BeginningYearBalanceAmt |
| Contributions | $304,703 | ContributionsAmt |
| Investment Earnings Or Losses | $241,350 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $676,074 | OtherExpendituresAmt |
| Administrative Expenses | $13,808 | AdministrativeExpensesAmt |
| End Year Balance | $2,715,895 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,681,098 | BeginningYearBalanceAmt |
| Contributions | $326,197 | ContributionsAmt |
| Investment Earnings Or Losses | $95,588 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $222,117 | OtherExpendituresAmt |
| Administrative Expenses | $21,042 | AdministrativeExpensesAmt |
| End Year Balance | $2,859,724 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,065,019 | BeginningYearBalanceAmt |
| Contributions | $1,990,675 | ContributionsAmt |
| Investment Earnings Or Losses | $117,527 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $473,098 | OtherExpendituresAmt |
| Administrative Expenses | $19,025 | AdministrativeExpensesAmt |
| End Year Balance | $2,681,098 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.32400 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.67600 | PrmnntEndowmentBalanceEOYPct |
| 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) |
|---|---|---|
| Investment Cost Or Other Basis | $920,642 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,890,511 | OtherCostOrOtherBasisAmt |
| Book Value | $3,811,153 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,664,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,291,270 | DepreciationAmt |
| Book Value | $37,373,519 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,280,059 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,921,846 | DepreciationAmt |
| Book Value | $9,358,213 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,544,087 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,680,342 | DepreciationAmt |
| Book Value | $5,863,745 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $56,406,630 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Interest in Avera Health Foundation | $3,247,396 | F |
| Interest in net assets of Mabee Trust | $808,294 | F |
| Assets Limited to use - Avera Pooled Investments | $59,910,560 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $63,966,250 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Derivative liability | $1,026,663 |
| Estimated third party payor settlements | $145,802 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,172,465 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The Organization holds funds in trust on behalf of its residents. |
| Part V, Line 4: | The organization's endowments consist of a portion of their interest in the net assets of Avera Health Foundation and their beneficial interest in the Mabee Trust. Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The endowment fund assets included in the Organization's beneficial interest in the Mabee Trust have been established to purchase equipment and furnishings for the Organization. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. The Organization currently does not have any board-designated endowment funds. Line 1e includes an adjustment of $2,077,965 to remove amounts previously reported as endowments in error. |
| Part X, Line 2: | Avera Health and most of its sponsored organizations are considered nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. These organizations are required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). Avera Health and certain sponsored organizations also file an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report their unrelated business taxable income. 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. The federal Form 990T filings and taxable subsidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2015. Certain consolidated entities are subject to federal income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. Deferred tax assets and liabilities are not material as of June 30, 2018 and 2017. The Organization paid an immaterial amount of federal and state income taxes for the years ended June 30, 2018 and 2017. |
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) |
|---|---|---|
| Persons Served | 2177 | PersonsServedCnt |
| Total Community Benefit Expns | $1,235,683 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,235,683 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5925 | PersonsServedCnt |
| Total Community Benefit Expns | $8,291,366 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,997,279 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,294,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8102 | PersonsServedCnt |
| Total Community Benefit Expns | $9,527,049 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,997,279 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,529,770 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04280 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $3,174 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $45,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $221,858 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $221,858 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $106,836 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $106,836 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $376,868 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $376,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Persons Served | 8102 | PersonsServedCnt |
| Total Community Benefit Expns | $9,903,917 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,997,279 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,906,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04630 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $5,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $5,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,400,706 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $40,920,117 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,115,289 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $7,804,828 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 3 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (3 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | |||||||||||
| 1 | 525 North Foster Street | Mitchell | SD | 57301 | www.averaqueenofpeace.org | 10552 | Yes (X) | Yes (X) | Yes (X) | 8 Provider Based Clinics | |
| Avera Weskota Memorial Medical Center | |||||||||||
| 2 | 609 1st Street NE | Wessington Springs | SD | 57382 | www.avera.org/weskota | 48209 | Yes (X) | Yes (X) | Yes (X) | ||
| Avera De Smet Memorial Hospital | |||||||||||
| 3 | 306 Prairie Avenue SW | De Smet | SD | 57231 | www.avera.org/de-smet | 50726 | Yes (X) | Yes (X) | Yes (X) | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Other CriteriaOtherCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP TranslatedFAPTranslatedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Other Actions TakenOtherActionsTakenInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Look Back Medicare PrivateLookBackMedicarePrivateInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 15 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | https://www.avera.org/about/community-health-needs-assessments/#queen | Yes (X) | Yes (1) | 15 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Weskota Memorial Medical Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 15 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | https://www.avera.org/about/community-health-needs-assessments/#weskota | Yes (X) | Yes (1) | 15 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera De Smet Memorial Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 3 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 15 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | https://www.avera.org/about/community-health-needs-assessments/#de-smet | Yes (X) | Yes (1) | 15 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | See Section V | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (20 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Avera Queen of Peace Hospital | Part V, Section B, Line 5: The Administrative Fellow, in collaboration with local organizations and individuals, obtained primary data pertaining to the primary service area from 97 individual surveys, 14 key informant individuals, four focus groups, and 10 sector policy and procedure checklists. Key informant and sector checklists were conducted with Davison County Health Department and Regional Health Department management as well as community members and organizations within the community representing a broad range of interests, including medically underserved, low income, and diverse populations. The public health departments provide services to individuals living in poverty and vulnerable populations. Of the persons seen at the regional health departments, 34% are of American Indian ethnicity; 17% alone for Davison County. Invitations to participate in focus groups were sent to community organizations and advertisements were placed in various local newspapers throughout the region. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 5: Avera Weskota Memorial Hospital gathered both primary and secondary data for the assessment. Primary data from three focus groups and written responses from individual surveys was collected and summarized by a Community Development Specialist from Planning & Development District II of Yankton, SD. Individuals representing a wide range of interests participated in the focus groups held at the Wessington Springs Community Club, the Wessington Springs Area Senior Citizens Center, and the Jerauld County Court House. Key community informants including the community health nurse were consulted and participated in committees that helped to prioritize the needs of the community. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 5: Avera De Smet Memorial Hospital partnered with the City of De Smet, De Smet Development Corporation, De Smet Chamber of Commerce, De Smet Event and Wellness Center and the School districts for De Smet, Iroquois, and Arlington to collect primary data from individual surveys and individual key informant interviews. Data was then evaluated and prioritized by a steering committee. |
| Avera Queen of Peace Hospital | Part V, Section B, Line 11: A. Behavioral Health ServicesBehavioral health has been identified an area of need that Avera Queen of Peace is addressing. Access to services, early intervention, and education are critical to achieving improved long-term outcomes for individuals and communities. The hospital has developed the following goals to address this need.1. Improve mental health and prevent crisis situations within our communities. 2. Improve recovery rates and reduce public health crisis related to alcohol and substance use disorders.3. Improve behavioral health and substance use disorders screening, wellness, and awareness through education and self-management programs. Progress toward these goals has included: * Avera Queen of Peace provided leadership expertise for the Mitchell Chamber Community Health and Wellness Fair. The wellness fair was open to the public free of charge. Vendors and programs that address behavioral health awareness and substance use disorders were invited and participated in the fair. * AQOP staff collaborated with local experts during Mitchell Chamber Community Health and Wellness Fair. B. Access to CareAccess to primary and mental healthcare services was identified as a priority of the community. Our goal is to improve access to primary care and mental health care services. Although great efforts have been made, much of the area is still designated a Primary Care Healthcare Professional Shortage Area and most of the area remains designated as a Medically Underserved Area/Population. Increasing access to primary care, specialties, and care coordination teams contributes to improved health outcomes. Access to services, early intervention, education, and support are critical to achieve improved long-term outcome for individuals and communities. Avera Queen of Peace continues to actively recruit family practice, internal medicine, obstetrics and gynecology, clinical psychology, radiology, and pediatric providers. Fiscal year 2018 recruitments included two hospitalists in the creation of a new program, along with new e-Hospitalist program to extend hours. Radiology was moved from a contracted service to and employment model. C. Prevention, Wellness, Screening and EducationOngoing education related to how physical and mental health issues impact overall health of an individual and learning to manage chronic disease conditions was identified to be a priority of the community. As the focus on community and population health increases, it becomes more critical to invest resources and create partnerships related to prevention, wellness, screenings and education. The hospital's education programs, participation in health fairs, and support group programs are intended to address community education and support. Personalized chronic disease management education and support are also essential to improve the overall health of individuals and communities. Partnerships and collaborations with health agencies, providers, and community organizations are essential to increase breadth and depth of prevention, wellness, screening, and education knowledge. The hospital has developed the following goals to address this need.1. Build a culture of health through collaborative prevention, wellness, screening and education. 2. Engage and empower individuals to actively manage their chronic disease through education and support. Progress toward these goals has included: * Added Planet Heart screening to our radiology menu of services. * Diabetic supply assistance to patients who cannot afford supplies (11 patients). * During year two of the Rural Electronic Gestational Diabetes Grant (eGDM) 61 patients were enrolled, 47 patients delivered and services were expanded to Yankton, Pierre, Gregory, and Wagner areas. * Stop the Bleed presentations and kits (Dakota Fest, 1st Aid education) * Avera Queen of Peace Foundation funded: 31 health screenings for breast and colorectal health, two educational events, 25 overnight stays for cancer patients, and 652 meals for cancer patients. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 11: The Health Education Team consists of representatives from Avera Weskota Memorial Hospital, Horizon Health Care, Weskota Manor Avera, and the South Dakota Department of Health, Jerauld County Office of Child and Family Services. The team's purpose is to provide health education to the community in the Wessington Springs area. The Health Education Team coordinates community education programs and health screenings at several events throughout the year. The three needs that will be addressed are: 1 Prevention/Wellness Care2 Community Education Regarding Mental Health Issues - Alcohol, Drug Use and Depression 3 Perceived Lack of Healthcare ServicesPrevention/Wellness Care: Goal # 1 - Provide and promote prevention and wellness education and screening opportunities to community members locally.Objective #1 - Provide and promote improvements in long term health as a result of physical activity by increasing access, education and event opportunities locally.Objective #2 - Provide and promote improvements in long term health as a result of good nutrition through prevention and wellness education and awareness opportunities locally.Objective #3 - Provide and promote overall health prevention and wellness education and awareness opportunities locally.Goal #1 Status Update: We participate in our local health fair, provide speakers for community events and organization an annual walk/run event on the 4th of July. We submit articles on a variety of topics to increase the education on health and wellness to our community and staff. Community Education Regarding Mental Health Issues- Alcohol, Drug Use, and DepressionGoal #1 - Provide and promote community education and individual services to increase awareness and understanding of behavioral health and substance use disorders.Objective # 1 - Provide and promote opportunities that increase education and awareness of depression.Objective #2 - Provide and promote screening and treatment options locally.Goal #1 Update: We provided a speaker to a local community group.Perceived Lack of Healthcare ServicesGoal #1 - Improve the perceived lack of healthcare services through communication, education, and community events.Objective #1 - Increase utilization of local health care services through awareness, education, and communication. Objective #2 - Increase awareness of services through communication and community events.Goal #1 Status Update: We have developed a Facebook page. We regularly submit educational articles to the local newspaper. We continue to create awareness of our services through social media, health fair, newspaper articles, and our fun run/walk event on the 4th of July. CHNA Needs Not Addressed:Though Avera Weskota Memorial Hospital is a leader in identifying the needs of the community, some needs fall outside the span of control of the hospital. Unmet needs identified by the 2016 Community Health Needs Assessment will be addressed by recommended community organizations. These unmet needs include: * Assisted Living: Assisted living was identified as a need in the community for the 2013 and 2016 CHNA. In 2013, this issue was referred to Weskota Manor Avera. Developing assisted living is in the nursing home's long range strategic plan, but it is not financially feasible at this time. The health care community, hospital advisory board, and nursing home governing board will be educated regarding this plan. Avera Weskota Memorial Hospital will refer the identified need to Weskota Manor Avera for consideration in their long range strategic planning.In-home services are available to assist tenants in the independent living apartments. Services include: skilled home health and hospice services, hot meal programs, bus transit services and homemaker programs. * Recruitment of Healthcare Workers: Recruitment of healthcare staff was also identified as a concern. Low unemployment rate as well as a shortage of healthcare and home maker program applicants is a problem across the state. The facility will continue to apply creative ideas to recruitment and will not pursue this as a community health needs priority. Avera Weskota Memorial Hospital and the other healthcare facilities will continue to work with this issue. The hospital is using the South Dakota Retention Bonus as an incentive to recruit and retain professional staff, in addition to loan forgiveness and bonuses. This incentive has helped recruit and retain some, but not all, staff. Avera Weskota is participating in a Margaret A. Cargill Foundation Grant with Dakota Wesleyan University to educate and prepare Certified Nursing Assistants (CNA) and nurses in rural communities. In addition, the hospital will participate with University of South Dakota and United States Department of Agriculture (USDA) project, a project whereby student education is delivered via telemedicine to rural students at the facility. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 11: The five priorities are more medical doctors locally, affordable housing, high cancer rates, need for mental health, and senior transport and activities. Avera De Smet Memorial Hospital leadership three year implementation plans will focus on the following prioritized needs: * More Medical Doctors locally (Access to Care)* High Cancer Rates (Wellness and Prevention Education and Screening)* Mental Health (Behavioral Health)Access to Care Goal #1 - Provide the residents of Kingsbury County better access to care locally.Objective # 1 - Recruit more medical doctors to our area for outreach services.Objective #2 - Recruit more providers to be credentialed to provide eCare Telemedicine services in our area.Objective #3 - Improve home health services in our service area.Status Update: We are involved in a group at the system level to address the needs and improve access to the needs of home health patients in our region. Wellness, Prevention Education, and ScreeningGoal #1 - Provide and promote prevention and wellness education and screening opportunities to community members locally. Objective #1 - Provide and promote cancer prevention and wellness education and screening opportunities locally.Objective #2 - Provide and promote chronic disease management prevention and wellness education locally.Objective #3 - Promote overall health education and awareness by supporting and participating in community events.Status Update: The system has developed educational topics that meet the objectives. The topics are sent to our local newspaper on a least a quarterly basis. The information is modified to be specific to our location and services.Behavioral Health Goal # 1 - Address the need for mental health services through satellite clinics or telemedicine.Objective #1 - Provide mental health screenings with primary care providers.Objective #2 - Increase the number of options and supports for patients seeking behavioral health services.Objective #3 - Increase community awareness and education of local services provided to community members.Status Update: A mental health screening was incorporated into the medical record.The following unmet needs that will not be addressed include affordable housing, senior transportation, and activities. These needs will be addressed by other organizations within the community.Avera Queen of Peace 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.Avera Weskota Memorial Medical Center:Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.Avera De Smet Memorial 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. |
| Avera Queen of Peace 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. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. |
| Avera De Smet Memorial 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. |
| Avera Queen of Peace 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera De Smet Memorial 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Queen of Peace 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera Weskota Memorial Medical Center | 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera De Smet Memorial 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. A plain language summary is offered to all uninsured patients at the time of registration. |
| Avera Queen of Peace 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. |
| Avera Weskota Memorial Medical Center | 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. |
| Avera De Smet Memorial 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, Section B, Line 10a: Implementation Strategy | The most recently adopted implementation strategy for each of the facilities has been posted to the following website:http://www.avera.org/app/files/public/67531/2016-chna-implementationplan-queen-of-peace.pdf |
| Schedule H, Part V, Lines 16a, 16b, and 16c: | https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Avera Brady Health and Rehab | ||||
| 500 S Ohman St | Mitchell | SD | 57301 | Nursing Home |
| 2 - Avera Brady Assisted Living | ||||
| 1414 W Cedar Ave | Mitchell | SD | 57301 | Assisted Living |
Supplemental Information Detail SupplementalInformationDetail (14 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 expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind donations, line 7i were compiled using actual costs recorded in the CBISA software. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. |
| Part I, Ln 7 Col(f): | Bad debt expense of $3,400,706 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage. |
| Part II, Community Building Activities: | Avera Queen of Peace supports numerous economic development organizations with participation at meetings and donations throughout its service area. Additionally, Avera Queen of Peace works with Dakota Wesleyan University, the Mitchell Technical Institute, and local high schools to address healthcare worker shortages in the communities of its service area. |
| Part III, Line 2: | Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Bad debt expense on line 2 is reported at charges as presented on the financial statements. |
| Part III, Line 3: | 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 III, Line 4: | The footnote to the Organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 10 of the attached audited financial statements. |
| Part III, Line 8: | 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. Avera Queen of Peace follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community. |
| Part III, Line 9b: | If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. |
| Part VI, Line 2: | Health care needs are assessed through various methods. Given Mitchell is a regional center/hub and the sixth largest city in South Dakota, Avera Queen of Peace is integrally involved with community organizations, universities/colleges, schools, state programs and local governments. The next largest hospital offering the same level of services is 72 miles from Mitchell and most of the towns within our region have a population of less than 2,000. By working with all in our region, we are able to determine health needs and provide programs and solutions where possible. In addition to activities reported in the Community Health Needs Assessment, Avera Queen of Peace, Avera Weskota and Avera De Smet collaborate with a community health committees within their respective community to assess and promote health related matters. |
| Part VI, Line 3: | A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and is included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Part VI, Line 4: | Avera Queen of Peace's service area includes Davison County and surrounding counties in South Dakota. In 2015, the population for Davison County was estimated to be 19,858. Approximately 17.7% of the population is age 65 or older. The average per capita income is $25,881 and approximately 13.4% of individuals are below the federal poverty level. The nearest like hospital in the area is approximately 72 miles from Avera Queen of Peace. |
| Part VI, Line 5: | Avera Queen of Peace is a State Certified Level #4 Community Trauma Center and operates an emergency department staffed 24 hours per day with board certified physicians. Emergency care is provided on an open door basis regardless of ability to pay. Avera Queen of Peace leases two critical access hospitals which provide a broad range of inpatient, outpatient services and 24 hour emergency rooms in two very rural communities.Avera Queen of Peace operated three rural health clinics during the year which provide primary care services in three rural communities.Similar to the hospitals in the Avera Queen of Peace region, the clinics are operated on an open door basis and care is provided regardless of ability to pay.Medical staff privileges are extended to all licensed and qualified applicants. The Avera Queen of Peace Board of Directors is principally comprised of community members from the primary and secondary services areas. Members come from a variety of backgrounds including banking, education, agriculture, healthcare and private industry. |
| 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Brian Kampmann MD | ||||||||||||||
| Board Member (thru Jan 2018) | $870,278 | $0 | $400,745 | $0 | $3,138 | $0 | $13,500 | $0 | $28,993 | $0 | $1,316,654 | $0 | $0 | $0 |
| Hillary Rockwell MD | ||||||||||||||
| Board Member/Physician | $412,014 | $0 | $14,979 | $0 | $30,028 | $0 | $13,500 | $0 | $28,756 | $0 | $499,277 | $0 | $0 | $0 |
| Aaron BaasBoard | ||||||||||||||
| Member/Physician (as of Feb 2018) | $449,264 | $0 | $160,855 | $0 | $30,294 | $0 | $13,500 | $0 | $28,993 | $0 | $682,906 | $0 | $0 | $0 |
| Thomas Clark | ||||||||||||||
| President & CEO | $0 | $372,788 | $0 | $800 | $0 | $125,622 | $0 | $13,500 | $0 | $27,274 | $0 | $539,984 | $0 | $0 |
| Jim Breckenridge | ||||||||||||||
| CFO Avera Health | $0 | $815,781 | $0 | $0 | $0 | $71,625 | $0 | $13,500 | $0 | $20,616 | $0 | $921,522 | $0 | $0 |
| William E Flett | ||||||||||||||
| Secretary | $69,087 | $112,195 | $0 | $0 | $240 | $12,528 | $3,633 | $6,474 | $11,028 | $15,401 | $83,988 | $146,598 | $0 | $0 |
| Chris Krouse DO | ||||||||||||||
| Orthopedics, Sports Medici | $1,038,026 | $0 | $368,044 | $0 | $4,882 | $0 | $13,500 | $0 | $23,503 | $0 | $1,447,955 | $0 | $0 | $0 |
| Kathleen Naegele DO | ||||||||||||||
| Hematology and Oncology | $540,563 | $0 | $15,000 | $0 | $67,369 | $0 | $13,500 | $0 | $24,656 | $0 | $661,088 | $0 | $0 | $0 |
| Xenofon Papadopoulos MD | ||||||||||||||
| Urology | $539,567 | $0 | $15,000 | $0 | $39,238 | $0 | $13,500 | $0 | $28,993 | $0 | $636,298 | $0 | $0 | $0 |
| Dennis Leland | ||||||||||||||
| General Surgery | $443,524 | $0 | $96,237 | $0 | $7,768 | $0 | $13,500 | $0 | $24,747 | $0 | $585,776 | $0 | $0 | $0 |
| Darren Manthey | ||||||||||||||
| Emergency Physician | $458,579 | $0 | $45,157 | $0 | $32,877 | $0 | $13,234 | $0 | $24,003 | $0 | $573,850 | $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 is compensated by Avera Health. Avera Queen of Peace relied on the related organization 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 (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Jim Breckenridge, Thomas Clark and Will Flett have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Avera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. |
| Form 990, Part VI, Section A, line 8b | Avera Queen of Peace Hospital does not have committees 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 15b | The CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera Queen of Peace. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents and conflict of interest policy are not available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public. |
| Form 990, Part IX, line 11g | Recruitment: Program service expenses 2,926. Management and general expenses 61,637. Fundraising expenses 0. Total expenses 64,563. Purchased Services: Program service expenses 3,554,157. Management and general expenses 189,598. Fundraising expenses 0. Total expenses 3,743,755. ACS Fees: Program service expenses 708,744. Management and general expenses 8,349,126. Fundraising expenses 0. Total expenses 9,057,870. Shared Services: Program service expenses 0. Management and general expenses 148,532. Fundraising expenses 0. Total expenses 148,532. |
| Form 990, Part XI, line 9: | Change in Fair Value of Interest Rate Swap 525,737. Equity Transfers -1,460,161. Change in Beneficial Interest in Mabee Trust 679. Change in Interest in Avera Foundation 399,718. |
| Form 990, Part XII, Line 2c: | The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements of Avera Health, which includes Avera Queen of Peace. |
| Form 990, Part VI, Section B, Line 16b: | There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. |
| Form 990, Part X, Line 20: | The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, Avera St. Anthony, Avera St.Benedict, Avera Holy Family, Avera Tyler, Avera Gettysburg, Avera at Home, and Avera Sacred Heart. 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). |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 West Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of Health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera St Anthony's Hospital | |||||||||||
| 300 N 2nd Street | ONeill | NE | 68763 | 470463911 | Healthcare Services | NE | 501(c)(3) | Line 3 | 0 | Avera Health | |
| 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 | |
| Avera Marshall | |||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 410919153 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| 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 | |||||||||||
| 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 | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare Services | SD | 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 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 Education and Service 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 Tyler | |||||||||||
| 240 Willow Street | Tyler | MN | 56178 | 410853163 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Health Plans Inc | |||||||||||
| 3900 West Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health Financing and Health Plan Admin | SD | 501(c)(4) | 0 | Avera Health | ||
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 |
|---|---|---|---|---|---|---|---|
| Q & M Properties LLC | |||||||
| 525 North Foster | Mitchell | SD | 57301 | 731652049 | Medical clinic building | SD | N/A |
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | |||||||
| 714 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 Ave 102 | Sioux Falls | SD | 57117 | 800619999 | medical services - home medical equipment | 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | |||||||||||||
| 5132 S Cliff Ave Suite 101 | Sioux Falls | SD | 57108 | 460373021 | collection agency | SD | N/A | C | 0 | ||||
| Avera Property Insurance Inc | |||||||||||||
| 610 W 23rd St Ste 1 PO Box 38 | Yankton | SD | 57078 | 460463155 | insurance | SD | N/A | C | 0 | ||||
| Dr Donald & Marguerite Mabee Trust | |||||||||||||
| c/o First National Bank of South Da | Mitchell | SD | 57301 | 466056202 | investing | SD | T | Yes (1) | Avera Queen of Peace Hospital | $18,242 | $808,294 | 1.00000 | |
| Valley Health Services | |||||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | rental real estate | SD | N/A | C | 0 | ||||
| Alucent Medical Inc | |||||||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | biotech research | SD | N/A | C | 0 | ||||
| South Dakota State Medical Holding Inc | |||||||||||||
| 2600 W 49th Street | Sioux Falls | SD | 57105 | 460401087 | insurance | SD | N/A | C | 0 | ||||
| DakotaCare Administrative Services Inc | |||||||||||||
| 2600 W 49th Street | Sioux Falls | SD | 57105 | 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 | Yes (1) | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |