AVERA HEALTH: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: AVERA HEALTH (EIN 46-0422673)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-15
IRS object ID: 201841359349301249
Schema version: 2016v3.0
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-15T07:47:32-05:00	ReturnTs
Tax Period End	2017-06-30	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	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460422673	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AVERA HEALTH	BusinessNameLine1Txt

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3900 WEST AVERA DRIVE No 300	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57108	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Jim Breckenridge	PersonNm
Person Title	Secretary/Treasurer	PersonTitleTxt
Phone	6053224700	PhoneNum
Signature	2018-05-10	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2018-05-10	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	198.135.125.11	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-05-10	IPDt
IP Tm	14:19:31	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC	AtSubmissionCreationDeviceId
At Submission Filing Device Id	29C631FCBD7EE613918B5A80576D837C30D7D376	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	John Porter	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3900 WEST AVERA DRIVE No 300	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57108	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$221,045,858	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.avera.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of Health	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	1381	TotalEmployeeCnt
Total Volunteers	35	TotalVolunteersCnt
Total Gross UBI	$327,831	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$179,911	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$17,527,901	PYContributionsGrantsAmt
CY Contributions Grants	$15,789,136	CYContributionsGrantsAmt
PY Program Service Revenue	$170,934,945	PYProgramServiceRevenueAmt
CY Program Service Revenue	$187,050,828	CYProgramServiceRevenueAmt
PY Investment Income	$2,733,287	PYInvestmentIncomeAmt
CY Investment Income	$15,603,501	CYInvestmentIncomeAmt
PY Other Revenue	$245,067	PYOtherRevenueAmt
CY Other Revenue	$450,275	CYOtherRevenueAmt
PY Total Revenue	$191,441,200	PYTotalRevenueAmt
CY Total Revenue	$218,893,740	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,992,337	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$5,790,679	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$98,056,871	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$110,023,045	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$67,343,079	PYOtherExpensesAmt
CY Other Expenses	$79,902,077	CYOtherExpensesAmt
PY Total Expenses	$171,392,287	PYTotalExpensesAmt
CY Total Expenses	$195,715,801	CYTotalExpensesAmt
PY Revenues Less Expenses	$20,048,913	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$23,177,939	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,018,218,771	TotalAssetsBOYAmt
Total Assets EOY	$1,067,436,720	TotalAssetsEOYAmt
Total Liabilities BOY	$744,633,910	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$755,278,638	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$273,584,861	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$312,158,082	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Avera Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$171,962,134	ExpenseAmt
Grant	$5,790,679	GrantAmt
Revenue	$186,830,145	RevenueAmt
Desc	Avera Health delivers health care to individuals and communities through a system of nearly 330 affiliated health care facilities, which are referred to collectively as "Avera." Avera, the health ministry of the Benedictine and Presentation Sisters, serves the people of eastern South Dakota and surrounding states with a wide spectrum of health services delivered through hospitals, long-term care facilities, clinics and other health programs.Avera Health VisionWorking with its partners, Avera Health shall provide a quality, cost-effective health ministry, which reflects Gospel values. We shall improve the health care of the people we serve through a regionally integrated network of persons and institutions.Avera ValuesIn caring for life, the Avera community is guided by the Gospel values of compassion, hospitality and stewardship.Avera is sponsored by the Benedictine Sisters of Yankton, S.D., and the Presentation Sisters of Aberdeen, S.D. In accordance with its Catholic mission, Avera adheres to "The Ethical and Religious Directives for Catholic Health Care Services".Avera facilities return any revenues over expenses that they receive to the people in their communities in three ways:We provide care of those who cannot afford to pay. Avera affiliates provide free or discounted health and health-related services to persons who cannot afford to pay all or part of a bill, including persons who are uninsured and low-income patients, using income-related discounts. As the number of uninsured persons grows, so does the need for charity care, or free or discounted health services provided to those who cannot afford to pay.Charity care/financial assistance is free or discounted health and health-related services provided to persons who cannot afford to pay all or part of a bill, including persons who are uninsured and low-income patients, using an income-related schedule. The dollar amount provided for charity care is based on the actual cost of providing that service, not the amount that would have been charged for that service. Charity care does not include bad debt.Medicaid, State Children's Health Insurance Program (SCHIP), local and state government programs that reimburse health care providers for persons not eligible for Medicaid and other government programs provide health coverage for thousands of individuals in our region. However, they generally do not reimburse hospitals and doctors for the full costs of services. In many instances, payment is based on data from previous years that doesn't accurately reflect the rapidly changing nature of health services, such as new processes, new equipment, new technologies and rising costs for supplies. In accordance with "A Guide for Planning and Reporting Community Benefit" (St. Louis: Catholic Health Association of the United States, 2008), unpaid costs of Medicare are not included in this amount. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs. These programs and services are not provided for marketing purposes. A community benefit must meet at least one of the following criteria: improve access to health care services; enhance health of the community; advance medical or health care knowledge; or relieve or reduce the burden of government or other community efforts. Included in this category are community health improvement services, health professions education, subsidized health services, research activities, financial and in-kind contributions, community-building and leadership activities and community-benefit-operations activities.Avera operates under the premise that social and institutional wellness are best promoted through joint efforts of various religious and community-sponsored institutions. Choosing collaboration and empowerment enables us to be better stewards of our human, financial, technical and environmental resources.Our caregivers are supported by the resources and expertise of the region's largest health system. Management and other support services are provided through the Avera Central Office, and Avera's six regional centers: Avera St. Luke's in Aberdeen, SD; Avera Marshall Regional Medical Center in Marshall, MN.; Avera Queen of Peace in Mitchell, SD; Avera St. Mary's in Pierre, SD; Avera McKennan in Sioux Falls, SD; and Avera Sacred Heart in Yankton, SD. As a leading health system in the region, Avera is committed to meeting the needs of communities it serves through the provision of quality health care services guided by Christian values and by making a positive impact on the community. Avera Health acts as the leader of the Avera health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. Through Avera Health, affiliates collaborate to improve the lives and health of individuals and of the communities we serve. This collaboration allows affiliates to access leading edge strategies and expertise while keeping administrative costs as low as possible.Avera Health serves health care facilities that are owned by Avera Health as well as facilities that are owned by local communities. Through Avera Health, affiliates are able to share costs of management, legal and other support services among many facilities rather than each facility incurring those costs separately. Avera Health provides a variety of services for the benefit of affiliates including coordinating the delivery of health care service to the region, overall strategic planning, group purchasing of supplies and services at lowest possible cost and education. Avera Health also coordinates joint investments and risk-management programs for affiliates.Avera eCARE is a visionary care delivery model that provides rural health care professionals around-the-clock access to specialty care physicians, nurses and pharmacists. Using advanced communication technology, eCARE supports rural facilities in the provision of evidence-based, high-quality care and offsets workforce shortages in rural communities. eCARE is a natural extension of Avera's Health mission and its century-long commitment to its rural communities to "maintain access to quality care close to home." Avera eCARE works with some of the most underserved populations in the United States. This includes frontier populations, long term care residents, Native American Reservations, disabled veterans, and inmates. By bringing high quality, on demand access to specialty care, these unique populations are able to receive care within their home community and in a familiar, culturally appropriate setting. They are treated in coordination with the local practitioners that best understand their ongoing care needs.	Desc
Total Program Service Expenses	$171,962,134	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	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	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	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	268	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1381	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	AL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	AR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CT	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	HI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MD	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MS	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NJ	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NM	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	ND	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	RI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	SC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	TN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	UT	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Jim Breckenridge	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053224700	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 (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Dan Eisenbraun
Chair	5.20	0.00	Yes (X)	Yes (X)	$0	$0	$0
Sister Debra Kolecka
Vice Chair	5.00	1.50	Yes (X)	Yes (X)	$0	$0	$0
Ken Karels
Director	5.00	0.00	Yes (X)		$0	$0	$0
Sister Mary Jaeger
Director	5.00	6.00	Yes (X)		$0	$0	$0
Sister Barbara McTague
Director	5.00	2.00	Yes (X)		$0	$0	$0
Sister Janet Horstman
Director	5.00	2.00	Yes (X)		$0	$0	$0
Sister JoAnn Sturzl
Director	5.00	2.00	Yes (X)		$0	$0	$0
Dr Merritt Gregg Warren
Director	5.00	40.00	Yes (X)		$0	$223,511	$26,529
Sister Mary Kay Panowicz
Director	5.00	0.00	Yes (X)		$0	$0	$0
Mark Shlanta
Director	5.00	0.00	Yes (X)		$0	$0	$0
Cathy Clark
Director	5.00	0.00	Yes (X)		$0	$0	$0
Dr J Michael Bacharach
Director	5.00	0.00	Yes (X)		$0	$0	$0
Dr Dale Vizcarra
Director	5.00	0.00	Yes (X)		$0	$0	$0
John Porter
President & CEO	40.00	2.00	Yes (X)	Yes (X)	$1,668,459	$0	$40,388
James Breckenridge
Sec/Treas & SrVP Finance	40.00	0.00		Yes (X)	$859,650	$0	$28,054
Fredrick Slunecka
Chief Operating Officer	40.00	0.00			$1,156,796	$0	$38,606	Yes (X)
David Flicek
Chief Administrative Officer	40.00	1.00			$609,904	$0	$38,280	Yes (X)
David Erickson
Sr VP Medical Affairs	40.00	0.00			$702,440	$0	$38,280		Yes (X)
Todd Forkel
Pres/CEO-St. Luke's	1.00	40.00			$652,544	$0	$41,576		Yes (X)
Richard Korman
Senior VP - General Counsel	1.00	40.00			$577,638	$0	$46,130		Yes (X)
David Kapaska
Pres/CEO-McKennan	1.00	40.00			$912,822	$0	$42,634		Yes (X)
James Veline
Senior VP - CIO	1.00	40.00			$555,850	$0	$29,710		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,696,103	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$223,511	TotReportableCompRltdOrgAmt
Total Other Compensation	$370,187	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	145	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
CDW Government
230 N Milwaukee Ave	Vernon Hills	IL	60061	Computer Hardware Consulting	$16,776,538
Avera McKennan
1325 S Cliff Avenue	Sioux Falls	SD	57117	Services, computer hardware & software	$9,525,769
Elekta
400 Perimeter Center Terrace Suite	Atlanta	GA	30346	Computer Hardware/Software/Consulting/Ca	$4,057,292
Medspeed
655 West Grand Avenue	Elmhurst	IL	60126	Courier Services	$3,529,604
Medical Information Technology
1 Meditech Circle	Westwood	MA	02090	Hardware/Software Consulting	$3,313,011

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	131	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$476,240	FederatedCampaignsAmt
Fundraising	$1,170,193	FundraisingAmt
Related Organizations	$146,686	RelatedOrganizationsAmt
Government Grants	$4,551,896	GovernmentGrantsAmt
All Other Contributions	$9,444,121	AllOtherContributionsAmt
Noncash Contributions	$511,928	NoncashContributionsAmt
Total Contributions	$15,789,136	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
ACS revenue	900099	$149,995,390	$149,995,390
eCare revenue	900099	$22,493,650	$22,493,650
PACE revenue	561000	$7,076,610	$6,406,640	$669,970
Premier expense credit	900099	$6,412,104	$6,412,104
Inc from affiliates	561000	$69,004	$518,291	-$449,287

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,004,070	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,004,070	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$187,050,828	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,768,304	TotalRevenueColumnAmt
Exclusion	$2,768,304	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,433,849	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,326,701	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$107,148	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$107,148	TotalRevenueColumnAmt
Unrelated Business Revenue	$107,148	UnrelatedBusinessRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$13,296,966	SecuritiesAmt
Other	$15,123	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$476,892	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$12,820,074	SecuritiesAmt
Other	$15,123	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,835,197	TotalRevenueColumnAmt
Exclusion	$12,835,197	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$691,652	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$1,170,193	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$348,525	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$343,127	TotalRevenueColumnAmt
Exclusion	$343,127	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$218,893,740	TotalRevenueColumnAmt
Related Or Exempt Func Income	$186,830,145	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$327,831	UnrelatedBusinessRevenueAmt
Exclusion	$15,946,628	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	$5,651,134	TotalAmt
Program Services	$5,651,134	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$139,545	TotalAmt
Program Services	$139,545	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,576,584	TotalAmt
Management And General	$4,576,584	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$80,940,997	TotalAmt
Program Services	$73,976,200	ProgramServicesAmt
Management And General	$6,964,797	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,667,429	TotalAmt
Program Services	$5,127,625	ProgramServicesAmt
Management And General	$539,804	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$13,570,625	TotalAmt
Program Services	$11,274,395	ProgramServicesAmt
Management And General	$2,296,230	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$5,267,410	TotalAmt
Program Services	$4,811,840	ProgramServicesAmt
Management And General	$455,570	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$65,166	TotalAmt
Management And General	$65,166	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,206,611	TotalAmt
Program Services	$773,833	ProgramServicesAmt
Management And General	$432,778	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$34,009,161	TotalAmt
Program Services	$28,365,946	ProgramServicesAmt
Management And General	$5,643,215	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$6,594,336	TotalAmt
Program Services	$6,590,618	ProgramServicesAmt
Management And General	$3,718	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,739,056	TotalAmt
Program Services	$5,359,916	ProgramServicesAmt
Management And General	$379,140	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$5,129,354	TotalAmt
Program Services	$5,114,222	ProgramServicesAmt
Management And General	$15,132	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,318,771	TotalAmt
Program Services	$3,019,814	ProgramServicesAmt
Management And General	$298,957	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,808,928	TotalAmt
Program Services	$1,677,811	ProgramServicesAmt
Management And General	$131,117	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,190,619	TotalAmt
Program Services	$1,122,517	ProgramServicesAmt
Management And General	$68,102	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$781,202	TotalAmt
Management And General	$781,202	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$16,664,099	TotalAmt
Program Services	$15,840,577	ProgramServicesAmt
Management And General	$823,522	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$214,132	TotalAmt
Program Services	$117,310	ProgramServicesAmt
Management And General	$96,822	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Grant Prog Expenditures	$1,125,436	$1,125,436
License & publications	$548,567	$542,110	$6,457
Foundation expenses	$539,782	$539,782
UBI tax	-$13,410		-$13,410

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$980,267	TotalAmt
Program Services	$791,503	ProgramServicesAmt
Management And General	$188,764	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$195,715,801	TotalAmt
Program Services	$171,962,134	ProgramServicesAmt
Management And General	$23,753,667	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,219,487	BOYAmt
EOY	$2,587,101	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$872,897	BOYAmt
EOY	$819,321	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,231,068	BOYAmt
EOY	$11,520,461	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$4,974,471	BOYAmt
EOY	$4,750,610	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$180,711	BOYAmt
EOY	$962,367	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,099,852	BOYAmt
EOY	$7,678,449	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$162,889,181	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$60,192,389	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$96,593,254	BOYAmt
EOY	$102,696,792	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$678,919,195	BOYAmt
EOY	$755,017,402	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$137,216,010	BOYAmt
EOY	$156,100,597	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$43,432	BOYAmt
EOY	$33,615	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,139,552	BOYAmt
EOY	$16,139,552	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$60,728,842	BOYAmt
EOY	$9,130,453	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,018,218,771	BOYAmt
EOY	$1,067,436,720	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$20,996,814	BOYAmt
EOY	$20,592,416	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$6,189,222	BOYAmt
EOY	$6,078,613	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,394,733	BOYAmt
EOY	$10,473,243	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$583,975,073	BOYAmt
EOY	$645,715,791	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$83,517,570	BOYAmt
EOY	$30,823,538	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,560,498	BOYAmt
EOY	$41,595,037	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$744,633,910	BOYAmt
EOY	$755,278,638	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$269,879,457	BOYAmt
EOY	$308,992,474	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,189,652	BOYAmt
EOY	$2,720,423	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$515,752	BOYAmt
EOY	$445,185	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$273,584,861	BOYAmt
EOY	$312,158,082	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,018,218,771	BOYAmt
EOY	$1,067,436,720	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$23,177,939	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,585,723	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$13,809,559	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$8,049,256	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$8,015,201	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$12,575,041	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$17,527,901	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,789,136	CurrentTaxYearAmt
Total	$61,956,535	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$92,494,783	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$125,942,998	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$150,269,980	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$170,255,307	CurrentTaxYearMinus1YearAmt
Current Tax Year	$186,832,895	CurrentTaxYearAmt
Total	$725,795,963	TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	$578,521	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$612,510	CurrentTaxYearMinus1YearAmt
Current Tax Year	$691,652	CurrentTaxYearAmt
Total	$1,882,683	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$100,544,039	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$133,958,199	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$163,423,542	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$188,395,718	CurrentTaxYearMinus1YearAmt
Current Tax Year	$203,313,683	CurrentTaxYearAmt
Total	$789,635,181	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	$5,755	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$78,763	CurrentTaxYearMinus1YearAmt
Current Tax Year	$33,177	CurrentTaxYearAmt
Total	$117,695	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$49,428,377	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$67,619,274	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$93,124,170	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$113,505,331	CurrentTaxYearMinus1YearAmt
Current Tax Year	$122,171,044	CurrentTaxYearAmt
Total	$445,848,196	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$49,428,377	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$67,619,274	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$93,129,925	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$113,584,094	CurrentTaxYearMinus1YearAmt
Current Tax Year	$122,204,221	CurrentTaxYearAmt
Total	$445,965,891	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$343,669,290	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$980,380	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$761,213	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$626,811	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$456,596	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,875,452	CurrentTaxYearAmt
Total	$5,700,452	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$980,380	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$761,213	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$626,811	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$456,596	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,875,452	CurrentTaxYearAmt
Total	$5,700,452	TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$328,468	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$105,051	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$129,714	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$92,791	CurrentTaxYearMinus1YearAmt
Total	$656,024	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$101,852,887	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$134,824,463	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$164,180,067	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$188,945,105	CurrentTaxYearMinus1YearAmt
Current Tax Year	$206,189,135	CurrentTaxYearAmt
Total	$795,991,657	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.43170	PublicSupportCY509Pct
Public Support PY509	0.45740	PublicSupportPY509Pct
Investment Income CY	0.00720	InvestmentIncomeCYPct
Investment Income PY	0.00600	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$49,040	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$46,611	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$2,957	OtherActivitiesAmt
Total Lobbying Expenditures	$98,608	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,854,052	BeginningYearBalanceAmt
Contributions	$583,639	ContributionsAmt
Investment Earnings Or Losses	$147,566	InvestmentEarningsOrLossesAmt
Other Expenditures	$548,377	OtherExpendituresAmt
Administrative Expenses	$32,869	AdministrativeExpensesAmt
End Year Balance	$5,004,011	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,361,194	BeginningYearBalanceAmt
Contributions	$413,851	ContributionsAmt
Investment Earnings Or Losses	$391,376	InvestmentEarningsOrLossesAmt
Other Expenditures	$277,515	OtherExpendituresAmt
Administrative Expenses	$34,854	AdministrativeExpensesAmt
End Year Balance	$4,854,052	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,542,771	BeginningYearBalanceAmt
Contributions	$367,555	ContributionsAmt
Investment Earnings Or Losses	$782,973	InvestmentEarningsOrLossesAmt
Other Expenditures	$296,350	OtherExpendituresAmt
Administrative Expenses	$35,755	AdministrativeExpensesAmt
End Year Balance	$4,361,194	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,302,432	BeginningYearBalanceAmt
Contributions	$477,896	ContributionsAmt
Investment Earnings Or Losses	$155,637	InvestmentEarningsOrLossesAmt
Other Expenditures	$370,880	OtherExpendituresAmt
Administrative Expenses	$22,314	AdministrativeExpensesAmt
End Year Balance	$3,542,771	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,046,321	BeginningYearBalanceAmt
Contributions	$328,355	ContributionsAmt
Investment Earnings Or Losses	$656,901	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,729,145	OtherExpendituresAmt
End Year Balance	$3,302,432	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.55520	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.23830	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.20650	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$13,544,035	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$948,600	OtherCostOrOtherBasisAmt
Book Value	$14,492,635	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$29,744,865	OtherCostOrOtherBasisAmt
Depreciation	$7,438,658	DepreciationAmt
Book Value	$22,306,207	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,988,005	OtherCostOrOtherBasisAmt
Depreciation	$2,025,687	DepreciationAmt
Book Value	$1,962,318	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$98,107,119	OtherCostOrOtherBasisAmt
Depreciation	$50,728,044	DepreciationAmt
Book Value	$47,379,075	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,556,557	OtherCostOrOtherBasisAmt
Book Value	$16,556,557	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$102,696,792	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Non-publicly traded hedge, private equity, debt, and multi-strategy funds	$126,628,933	F
Non-publicly traded real estate	$16,022,704	F
NPPC, LLC	$100,000	C
Premier Purchasing Partners, L.P.	$857,551	F
Interest in Innovation Institute	$12,491,409	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$156,100,597	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Estimated insurance claims payable	$37,276,254
Bond interest payable	$4,318,783

Field	Value	IRS element (for citing)
Total Liability	$41,595,037	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements.
Part V, Line 4:	The Organization's endowment consists of approximately 98 individual funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations.
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 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 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 2014.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean -	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investments reported on cost basis	TypeOfActivitiesConductedTxt
Region Total Expenditures	$84,314,422	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continutation Total Office	0	ContinutationTotalOfficeCnt
Continutation Total Employee	0	ContinutationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$84,314,422	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$84,314,422	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Race Against Breast Cancer	Event1Nm
Gross Receipts Event1	$526,796	GrossReceiptsEvent1Amt
Charitable Contri Event1	$340,777	CharitableContriEvent1Amt
Gross Revenue Event1	$186,019	GrossRevenueEvent1Amt
Food And Beverage Event1	$3,903	FoodAndBeverageEvent1Amt
Entertainment Event1	$578	EntertainmentEvent1Amt
Event2	The Big Grape Reserve	Event2Nm
Gross Receipts Event2	$243,850	GrossReceiptsEvent2Amt
Charitable Contri Event2	$204,988	CharitableContriEvent2Amt
Gross Revenue Event2	$38,862	GrossRevenueEvent2Amt
Food And Beverage Event2	$20,437	FoodAndBeverageEvent2Amt
Entertainment Event2	$1,000	EntertainmentEvent2Amt
Other Events Total	23	OtherEventsTotalCnt
Gross Receipts Other Events	$1,091,199	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$624,428	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$466,771	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$322,607	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$1,861,845	GrossReceiptsTotalAmt
Charitable Contributions Tot	$1,170,193	CharitableContributionsTotAmt
Gross Revenue Total Events	$691,652	GrossRevenueTotalEventsAmt
Food And Beverage Total Events	$24,340	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$1,578	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$322,607	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$348,525	DirectExpenseSummaryEventsAmt
Net Income Summary	$343,127	NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (87 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Aberdeen Catholic School System
1400 N Dakota St	Aberdeen	SD	57401	460336005	501(c)(3)	$93,621	Sponsorship
Aberdeen Christian School Inc
1500 E Melgaard Rd	Aberdeen	SD	57401	911806433	501(c)(3)	$10,000	Sponsorship
Aberdeen Development Corporation
416 Production St N	Aberdeen	SD	57401	466011831	501(c)(6)	$7,500	Sponsorship
Aberdeen Family Y Foundation Inc
5 South State Street	Aberdeen	SD	57401	460419782	501(c)(3)	$5,000	Community Benefit
Aberdeen Ride Line
205 N 4th St	Aberdeen	SD	57401	466000010	501(c)(3)	$12,960	Community Benefit
Aberdeen United Way
202 S Main St 200	Aberdeen	SD	57401	237086355	501(c)(3)	$5,000	Community Benefit
Avera St Mary's Foundation
801 E Sioux	Pierre	SD	57501	460230199	501(c)(3)	$10,000	Sponsorship
Boys and Girls Club of Aberdeen
1111 1st Ave SE	Aberdeen	SD	57401	237062273	501(c)(3)	$5,000	Community Benefit
Boys and Girls Club of the Sioux Empire
824 E 14th St	Sioux Falls	SD	57104	460399482	501(c)(3)	$7,500	Community Benefit
Boys and Girls Club of Yankton
2008 Mulberry St	Yankton	SD	57078	731630215	501(c)(3)	$40,000	Community Benefit
Brandon Valley Booster Club
301 S Splitrock Blvd	Brandon	SD	57005	460393971	501(c)(3)	$6,500	Sponsorship
Brookings Health System
300 22nd Ave	Brookings	SD	57006	466000069	501(c)(3)	$35,000	Sponsorship
Butterfly House & Aquarium
4320 S Oxbow Ave	Sioux Falls	SD	57106	522370420	501(c)(3)	$7,000	Sponsorship
Canton School District
800 N Main St	Canton	SD	57013	466002143	City of Canton	$10,000	Sponsorship
Career & Technical Education Academy
4700 W Career Cir	Sioux Falls	SD	57107	466002586	501(c)(3)	$10,000	Sponsorship
Catholic Community Foundation for Eastern SD
523 N Duluth Ave	Sioux Falls	SD	57104	466000424	501(c)(3)	$100,000	Sponsorship
Charis Ministry Partners
1300 E 10th St	Sioux Falls	SD	57103	383775128	501(c)(3)	$6,000	Community Benefit
Children's Home Society of South Dakota
801 N Sycamore Ave	Sioux Falls	SD	57110	460224542	501(c)(3)	$6,000	Community Benefit
Coalition to Protect American's Healthcare
PO Box 30211	Bethesda	MD	20824	522253225	501(c)(4)	$30,000	Sponsorship
Corn Palace
604 N Main St	Mitchell	SD	57301	460422673	City of Mitchell, SD	$5,000	Sponsorship
Dakota Heartland Development Association
PO Box 1087	Mitchell	SD	57301	460394983	501(c)(6)	$5,000	Sponsorship
Dakota Wesleyan University
1200 W University Ave	Mitchell	SD	57301	460224589	501(c)(3)	$30,000	Sponsorship
Dakotabilities Inc
1116 S 4th Ave	Sioux Falls	SD	57105	460306216	501(c)(3)	$12,000	Community Benefit
Daktronics Inc
PO Box 86	Minneapolis	MN	55486	460306862	501(c)(3)	$15,000	Sponsorship
Destiny Healthcare International
1417 S Minnesota Ave	Sioux Falls	SD	57105	510529480	501(c)(3)	$15,000	Community Benefit
Downtown Sioux Falls Inc
230 S Phillips Ave 102	Sioux Falls	SD	57104	363627217	501(c)(4)	$5,000	Sponsorship
EmBeYWCA
300 W 11th St	Sioux Falls	SD	57104	460234998	501(c)(3)	$59,000	Sponsorship
Etc for Her
1112 S Holly Ave	Sioux Falls	SD	57105	460422673		$19,000	Sponsorship
Face It Together Sioux Falls
231 S Phillips Ave 201	Sioux Falls	SD	57101	943472044	501(c)(3)	$15,000	Community Benefit
Family Visitation Center
311 E 14th St	Sioux Falls	SD	57104	263654937	501(c)(3)	$12,000	Community Benefit
Feeding South Dakota
4701 N Westport Ave	Sioux Falls	SD	57107	363293534	501(c)(3)	$25,000	Community Benefit
South Dakota Golf Association Junior Golf Foundation
2604 W Russell St	Sioux Falls	SD	57104	460449824	501(c)(3)	$5,000	Sponsorship
Flandreau High School
600 W Community Dr	Flandreau	SD	57028	460422673	City of Flandreau	$5,000	Sponsorship
Forward Sioux Falls
PO Box 907	Sioux Falls	SD	571010907	460396647		$150,000	Community Benefit
Furniture Mission of South Dakota
209 N Nesmith Ave	Sioux Falls	SD	57103	810584450	501(c)(3)	$8,000	Community Benefit
Goodwill of the Great Plains
3100 W 4th St	Sioux City	IA	51103	420727509	501(c)(3)	$53,141	Sponsorship
Ground Works Midwest
201 N Weber Ave	Sioux Falls	SD	57103	475498537	501(c)(3)	$5,000	Community Benefit
Harrisburg School District
PO Box 187	Harrisburg	SD	57032	466002218	City of Harrisburg	$25,000	Sponsorship
Philanthropy Promotions Inc
2601 W 60th St N	Sioux Falls	SD	57107	870695596	501(c)(3)	$7,500	Sponsorship
Friends of Levitt Shell Sioux Falls Inc
131 E Falls Park Dr	Sioux Falls	SD	57104	611699910	501(c)(3)	$50,000	Sponsorship
LifeLight Communications Inc
2601 S Western Ave	Sioux Falls	SD	57105	460460742	501(c)(3)	$25,000	Sponsorship
LifeScape Foundation
2011 W 26th St Ste 201	Sioux Falls	SD	57105	460353254	501(c)(3)	$12,500	Community Benefit
Lutheran Social Services
705 E 41st St 200	Sioux Falls	SD	57105	460224731	501(c)(3)	$50,000	Community Benefit
McCrossan Foundation Inc
47135 260th St	Sioux Falls	SD	57107	460241590	501(c)(3)	$11,000	Sponsorship
Mitchell Area Cooperative
PO Box 1087	Mitchell	SD	57301	460394983		$5,500	Sponsorship
Mitchell Technical Institute Foundation
1800 E Spruce St	Mitchell	SD	57301	460452950	501(c)(3)	$45,000	Sponsorship
Mitchell United Way
304 N Lawler St	Mitchell	SD	57301	461250302	501(c)(3)	$5,000	Community Benefit
Mount Marty College
1105 W 8th St	Yankton	SD	57078	460283336	501(c)(3)	$50,000	Sponsorship
Northern State University
1200 S Jay St	Aberdeen	SD	57401	460422673	State of SD	$150,000	Sponsorship
OLLI at University Center
4801 N Career Ave	Sioux Falls	SD	571071329	466000364	501(c)(3)	$7,500	Community Benefit
Parkston Area Development Corporation
PO Box 772	Parkston	SD	573660772	460444442	501(c)(6)	$50,000	Community Benefit
Pierre Post 8 Baseball
Hyde Baseball Stadium	Pierre	SD	57501	466008690	501(c)(19)	$10,000	Sponsorship
Pierre School District
211 Poplar St	Pierre	SD	57501	466001892	City of Pierre	$6,600	Sponsorship
Presentation College
1500 N Main St	Aberdeen	SD	57401	460280847	501(c)(3)	$50,000	Community Benefit
Pride in the Tiger Foundation
400 Tiger Dr	Marshall	MN	56258	411948007	501(c)(3)	$10,000	Sponsorship
Redwood Area Communities Foundation
901 Cook St	Redwood Falls	MN	56283	416005484	501(c)(3)	$5,000	Sponsorship
Ronald McDonald House Charities of South Dakota Inc
808 E 24th St	Sioux Falls	SD	57105	460371152	501(c)(3)	$20,000	Community Benefit
Central SD RSVP
801 E Dakota Ave	Pierre	SD	57501	460378424	501(c)(3)	$10,000	Community Benefit
Safe Harbor
PO Box 41	Aberdeen	SD	574020041	460344310	501(c)(3)	$10,000	Community Benefit
Sculpture Walk
300 S Phillips Ave L104	Sioux Falls	SD	57104	208535871	501(c)(3)	$11,000	Sponsorship
Sioux Center Hospital and Health Center Foundation
1101 9th St SE	Sioux Center	IA	51250	420796764	501(c)(3)	$10,000	Community Partnership
Sioux Council Boy Scouts of America
800 N West Ave	Sioux Falls	SD	57104	460224599	501(c)(3)	$5,000	Sponsorship
Sioux Empire Baseball Association
1601 W 44th Pl Ste 3	Sioux Falls	SD	571056377	411903475	501(c)(3)	$16,000	Sponsorship
Sioux Empire Fastpitch Softball Association
PO Box 88206	Sioux Falls	SD	57109	237223489	501(c)(3)	$7,500	Sponsorship
Sioux Empire United Way
1000 N West Ave Ste 120	Sioux Falls	SD	571041332	460233701	501(c)(3)	$80,000	Sponsorship
Sioux Falls CASA
300 N Dakota Ave 609	Sioux Falls	SD	57104	460430647	501(c)(3)	$5,000	Community Benefit
Sioux Falls Catholic Schools
3100 W 41st St	Sioux Falls	SD	57105	460413591	501(c)(3)	$900,000	Sponsorship
Sioux Falls Jazz & Blues Society
PO Box 1285	Sioux Falls	SD	571011285	460418356	501(c)(3)	$20,000	Sponsorship
Sioux Falls Youth Hockey Assoc
4235 W Mesa Pass	Sioux Falls	SD	57106	460427805	501(c)(3)	$17,500	Sponsorship
SME of Sioux Falls
PO Box 90310	Sioux Falls	SD	571090310	466012934	501(c)(6)	$5,997	Sponsorship
South Dakota Ag & Rural Leadership
Box 2170 Animal Science Center 132	Brookings	SD	57007	364293293	501(c)(3)	$10,000	Sponsorship
South Dakota Parks and Wildlife Foundation
523 E Capitol	Pierre	SD	57501	460387968	501(c)(3)	$5,000	Sponsorship
SD HOSA
1400 W 22nd St	Sioux Falls	SD	57105	460422673	501(c)(3)	$25,000	Sponsorship
South Dakota State University
815 Medary Ave Box 525	Brookings	SD	57007	466000364	State of SD	$1,528,000	Sponsorship
South Dakota Symphony Orchestra
301 S Main Ave	Sioux Falls	SD	57104	466017026	501(c)(3)	$41,000	Sponsorship
Southeast Tech Foundation
2320 N Career Ave	Sioux Falls	SD	57107	364112897	501(c)(3)	$20,000	Community Benefit
Special Olympics of South Dakota
800 E I-90 Lane	Sioux Falls	SD	57104	460359776	501(c)(3)	$52,500	Sponsorship
The Banquet
900 E 8th St	Sioux Falls	SD	57103	460387495	501(c)(3)	$5,000	Community Benefit
Capital Area United Way
800 W Dakota Ave	Pierre	SD	57501	460403398	501(c)(3)	$5,000	Community Benefit
United Way of Greater Yankton
610 W 23rd St 11	Yankton	SD	57078	460252854	501(c)(3)	$12,000	Community Benefit
United Way of Southwest Minnesota
109 S 5th St 300	Marshall	MN	56258	416023143	501(c)(3)	$5,000	Community Benefit
University of Sioux Falls
1101 W 22nd St	Sioux Falls	SD	57105	460224600	501(c)(3)	$400,000	Sponsorship
Volunteers of America
PO Box 89306	Sioux Falls	SD	57109	237353508	501(c)(3)	$15,000	Sponsorship
Washington High School
501 N Sycamore Ave	Sioux Falls	SD	57110	466002586	City of Sioux Falls	$17,000	Sponsorship
Washington Pavilion
301 S Main Ave	Sioux Falls	SD	57104	460435791	501(c)(3)	$55,000	Sponsorship
Yankton Area Progressive Growth
803 E 4th St	Yankton	SD	57078	460348636	501(c)(6)	$60,000	Sponsorship
Yankton County Historical Society
610 Summit St	Yankton	SD	57078	466012522	501(c)(3)	$50,000	Sponsorship

Field	Value	IRS element (for citing)
Total501c3 Org	76	Total501c3OrgCnt
Total Other Org	11	TotalOtherOrgCnt

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

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
Haiti scholarships	22	$26,100
Premium assistance to employees	63	$113,445

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The Organization makes grants to other organizations exempt under 501(c)(3) to ensure the funds will be used for charitable purposes. During the year ending June 30, 2017, the Organization made contributions to other non-public charities in furtherance of community development. The contributions are approved by the Board for this purpose. Scholarship funds have different sets of criteria for determining eligibility and winners. Assistance to individuals is determined with assistance from each hospital's social services department or within a committee at the hospital.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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 (10 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
Dr Merritt Gregg Warren
Director	$0	$218,497	$0	$0	$0	$5,014	$0	$4,497	$0	$22,838	$0	$250,846	$0	$0
John Porter
President & CEO	$1,213,711	$0	$0	$0	$454,748	$0	$15,900	$0	$24,488	$0	$1,708,847	$0	$0	$0
James Breckenridge
Sec/Treas & SrVP Finance	$627,758	$0	$0	$0	$231,892	$0	$15,900	$0	$12,154	$0	$887,704	$0	$0	$0
Fredrick Slunecka
Chief Operating Officer	$857,381	$0	$0	$0	$299,415	$0	$15,900	$0	$22,706	$0	$1,195,402	$0	$0	$0
David Flicek
Chief Administrative Officer	$484,384	$0	$0	$0	$125,520	$0	$15,900	$0	$23,186	$0	$648,990	$0	$0	$0
David Erickson
Sr VP Medical Affairs	$553,781	$0	$0	$0	$148,659	$0	$15,900	$0	$23,186	$0	$741,526	$0	$0	$0
Todd Forkel
Pres/CEO-St. Luke's	$488,898	$0	$0	$0	$163,646	$0	$19,196	$0	$23,186	$0	$694,926	$0	$0	$0
Richard Korman
Senior VP - General Counsel	$454,445	$0	$0	$0	$123,193	$0	$21,200	$0	$25,736	$0	$624,574	$0	$0	$0
David Kapaska
Pres/CEO-McKennan	$680,086	$0	$0	$0	$232,736	$0	$21,200	$0	$21,434	$0	$955,456	$0	$0	$0
James Veline
Senior VP - CIO	$410,676	$0	$0	$0	$145,174	$0	$21,200	$0	$8,837	$0	$585,887	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 1a	FormAndLineReferenceDesc
Explanation	All Senior Executives are eligible for $2,500 per year to pay for social club dues. If an employee chooses to take advantage of this benefit, the amount is included in their taxable income. Those paid: John Porter $2,500 David Kapaska 2,043 James Breckenridge 2,500 Fredrick Slunecka 2,500	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VUS1	2012-05-01	$206,383,927	2012A funded a project and refunded Series 2008A and Series 2002	0	0	0
South Dakota Health and Educational Facilities Authority
B	460315509	83755VNH3	2008-07-01	$61,495,000	2008C refunded 2006 Series	0	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	83755VNB6	2008-06-18	$189,222,932	2012B refunded Series 1994, 2000, and bridge loan	0	0	0
South Dakota Health and Educational Facilities Authority
D	460315509	83755VVY7	2014-06-26	$61,821,688	2014A Various capital projects	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Credit EnhancementCreditEnhancementAmt
A	$142,153,927	$206,383,927	$1,032,422	$38,100,000	$167,251,505	2014	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	$5,745,000	$61,495,000	$388,831		$61,075,000	2010	Yes (1)	0	Yes (1)	Yes (1)	$31,169
C	$68,487,932	$189,222,932	$1,272,562	$91,009,361	$96,658,796	2010	Yes (1)	0	Yes (1)	Yes (1)	$282,213
D		$61,821,688	$821,688	$61,000,000		2015	0	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Business Name Line2HedgeProviderName/BusinessNameLine2Txt	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	0	0	0	Yes (1)	Yes (1)	0	0	0	Yes (1)
Bank of
B	0	0	0	Yes (1)	Yes (1)	Yes (1)	0	0	Yes (1)	America/Merrill	25.000000000000	0	Yes (1)
Bank of
C	0	0	0	Yes (1)	Yes (1)	Yes (1)	0	0	Yes (1)	America/Merrill	24.100000000000	0	0
(no name)
D	0	Yes (1)	0	0	0	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule K, Part IV, Line 2C:	The arbitrage analysis is performed annually, therefore the analysis was completed as of June 30, 2017 for Bonds A, B, C, and E.
Schedule K, Series 2008B	The bond issued 6/18/08 consisted of Series 2008A in the amount of $139,205,000 and 2008B in the amount of $50,320,000. Series 2008A bond was paid off with the issuance of the 2012A bond. The 2008B bond is interest only payments until 7/01/2038.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	South Dakota Health and Educational Facilities Authority	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	460315509	BondIssuerEIN
CUSIP	83755VNB6	CUSIPNum
Bond Issued	2008-06-18	BondIssuedDt
Issue Price	$189,222,932	IssuePriceAmt
Purpose	2008B refund bonds issued 1/12/1995 and 3/01/2000 and capital expenditures	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$189,222,932	TotalProceedsAmt
Issuance Costs From Proceeds	$1,272,562	IssuanceCostsFromProceedsAmt
Credit Enhancement	$282,213	CreditEnhancementAmt
Capital Expenditures	$149,849,658	CapitalExpendituresAmt
Other Spent Proceeds	$37,818,499	OtherSpentProceedsAmt
Substantial Completion	2010	SubstantialCompletionYr
Current Refunding	Yes (1)	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	Yes (1)	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	14	ContributionCnt
Noncash Contributions Rpt F990	$326,664	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Avg of high/low	MethodOfDeterminingRevenuesTxt

Real Estate Other RealEstateOtherGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$95,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Amount over FMV of land	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (14 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	Art	4	$34,000	cost
Yes (X)	Staging, sound, lights	1	$15,750	cost
Yes (X)	1929 Ford Model A	1	$12,000	cost
Yes (X)	Drawstring bags	1	$7,000	cost
Yes (X)	Yamaha Clavinova Piano	1	$6,900	cost
Yes (X)	Merchandise	1	$5,000	cost
Yes (X)	Lowry Organ Model 510 DXL	1	$5,000	cost
Yes (X)	Concert tickets and golf items	1	$1,650	cost
Yes (X)	100 baby blankets	1	$1,000	cost
Yes (X)	Twins tickets and suite	1	$900	cost
Yes (X)	Wine	1	$465	cost
Yes (X)	Minnesota Wild signed jersey and stick	1	$425	cost
Yes (X)	Harley Davidson merchandise	1	$140	cost
Yes (X)	Jams and jelly	1	$34	cost

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

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 32b:	Avera Health uses third parties to process and sell the stocks received.
Part I, Line 33:	The only amounts included in revenue for the financial statement reporting are non-cash contributions of stock securities. Non-cash contributions not included for financial statements include items for the benefit of the Avera facilities which include special event donations.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 6	The organization has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of six Sisters- three Presentation Sisters appointed by the Presentation Sponsorship Members and three Benedictine Sisters appointed by the Benedictine Sponsorship Members.
Form 990, Part VI, Section A, line 7a	The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health.
Form 990, Part VI, Section A, line 7b	The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the President and Chief Executive Officer; (e) To review and approve the operating and capital budgets, including expenditures outside of budget, and the strategic plan, of Avera Health; (f) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (g) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (h) To adopt policies designed to effectuate the powers reserved to the System Members; and (i) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members.
Form 990, Part VI, Section A, line 8b	Avera Health does not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11b	The Form 990 is reviewed by the CEO and CFO. After initial reviews, the return is provided to the board prior to filing.
Form 990, Part VI, Section B, line 12c	The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board.
Form 990, Part VI, Section B, line 15	Annually the Compensation Committee of Avera Health, which is comprised of six (6) system members appointed by the religious orders, meets with an independent consultant regarding fair market value for compensation of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.
Form 990, Part VI, Section C, line 19	The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public.
Form 990, Part IX, line 11g	Purchased services: Program service expenses 335,452. Management and general expenses 6,308. Fundraising expenses 0. Total expenses 341,760. Contracted services: Program service expenses 26,315,497. Management and general expenses 5,477,688. Fundraising expenses 0. Total expenses 31,793,185. Repairs and maintenance: Program service expenses 1,335,210. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,335,210. Professional fees: Program service expenses 16,393. Management and general expenses 159,219. Fundraising expenses 0. Total expenses 175,612. Recruitment: Program service expenses 363,394. Management and general expenses 0. Fundraising expenses 0. Total expenses 363,394.
Form 990, Part X, Line 20:	Avera Health is only disclosing a portion of the tax exempt bonds on Part X, Line 20. The bonds were issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, and Avera Sacred Heart. In accordance with IRS Instructions, information related to the entire tax exempt bond reporting is being reported on Avera Health's tax return on Schedule K.
Form 990, Part XI, line 9:	Net equity transfers 12,514,356. Insurance program admin income not recognized for tax reporting 13,026,668. Change in interest in net assets of foundations and trusts -61,649. Contributions received by Foundation - not reflected in financial statement -10,658,556. Net assets released from restrictions -1,011,260.
Form 990, Part VI Question 16b:	There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Communication LLC
3900 West Avera Drive Suite 300	Sioux Falls	SD	571085434	460453770	Telecommunications	SD	$1,138,676	$411,847	Avera Health
Avera eCare LLC
3900 West Avera Drive	Sioux Falls	SD	571085721		Telehealth	SD	$22,493,650	$0	Avera Health

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare services	NE	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Holy Family
826 North 8th Street	Estherville	IA	51334	420680370	Healthcare services	IA	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Holy Family Foundation
826 North 8th Street	Estherville	IA	51334	421317452	Support of Holy Family Hospital and Home Health Agency	IA	501(c)(3)	Line 10	Avera Holy Family	0
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
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	St Benedict Health Center	0
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Queen of Peace Hospital
525 North Foster	Mitchell	SD	57301	460224604	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare services	SD	501(c)(3)	Line 3	Avera St Mary's	0
Avera at Home
5116 S Solberg Ave	Sioux Falls	SD	57108	460399291	Home services	SD	501(c)(3)	Line 10	Avera Health	Yes (1)
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	Sacred Heart Health Services	0
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare services	SD	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Marshall
300 S Bruce Street	Marshall	MN	56258	410919153	Healthcare services	MN	501(c)(3)	Line 3	Avera Health	Yes (1)
Avera Tyler
240 Willow Street	Tyler	MN	56178	410853163	Healthcare services	MN	501(c)(3)	Line 3	Avera Marshall	0
Avera Health Plans Inc
3900 West Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health financing & health plan admin	SD	501(c)(4)		Avera Health	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 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
Q&M Properties LLC
525 North Foster	Mitchell	SD	57301	731652049	Medical clinic building	SD	N/A
Surgical Associates Endoscopy Clinic LLC
310 S Penn	Aberdeen	SD	57401	460461429	Surgical associates	SD	N/A
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota Ave	Sioux Falls	SD	57117	800619999	Medical Services - home medical equipment	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	Healthcare Services	SD	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Accounts Management Inc
5132 S Cliff Ave Suite 101	Sioux Falls	SD	57108	460373021	Collection agency	SD	Avera Health	C	$2,679,528	$2,501,027	0.75000	Yes (1)
Avera Property Insurance Inc
610 W 23rd St PO Box 38	Yankton	SD	57078	460463155	Insurance	SD	Avera Health	C	$435,365	$1,186,748	1.00000	Yes (1)
Valley Health Services
501 Summit Street	Yankton	SD	57078	460357149	Rental real estate	SD		C				0	N/A
Alucent Medical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	Biotech Research	SD		C				0	N/A
South Dakota State Medical Holding Company Inc
2600 W 49th Street	Sioux Falls	SD	57105	460401087	Insurance	SD	Avera Health	C	$79,380,363	$26,074,630	1.00000	Yes (1)
DakotaCare Administrative Services Inc
2600 W 49th Street	Sioux Falls	SD	57105	460424322	Insurance	SD	Avera Health	C	$8,150,084	$6,308,067	1.00000	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	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	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (30 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera Marshall
D	$249,539	Change in note receivable
Avera St Mary's
D	$194,769	Change in note receivable
Accounts Management Inc
L	$385,560	General ledger
Avera at Home
L	$1,361,434	General ledger
Avera Health Plans Inc
L	$425,000	General ledger
Avera Marshall
L	$5,537,507	General ledger
Avera McKennan
L	$81,507,000	General ledger
Avera Queen of Peace Hospital
L	$10,790,714	General ledger
Avera Sacred Heart Health Services
L	$13,606,646	General ledger
Avera St Luke's
L	$15,996,620	General ledger
Avera St Mary's
L	$6,952,794	General ledger
Dakotacare
L	$100,000	General ledger
Avera Marshall
P	$553,032	Vendor payment listing
Avera McKennan
P	$8,165,161	Vendor payment listing
Avera Queen of Peace Hospital
P	$166,116	Vendor payment listing
Avera Sacred Heart Health Services
P	$282,122	Vendor payment listing
Avera St Luke's
P	$196,705	Vendor payment listing
Avera St Mary's
P	$69,640	Vendor payment listing
Accounts Management Inc
P	$70,846	Vendor payment listing
Avera Health Plans Inc
P	$317,737	Vendor payment listing
Avera at Home
Q	$512,541	Customer invoice listing
Avera Marshall
Q	$1,709,958	Customer invoice listing
Avera McKennan
Q	$25,996,740	Customer invoice listing
Avera Queen of Peace Hospital
Q	$4,170,768	Customer invoice listing
Avera Sacred Heart Health Services
Q	$6,347,455	Customer invoice listing
Avera St Luke's
Q	$7,418,718	Customer invoice listing
Avera St Mary's
Q	$2,664,298	Customer invoice listing
Accounts Management Inc
Q	$111,658	Customer invoice listing
Avera Health Plans Inc
Q	$130,384	Customer invoice listing
Avera St Luke's
C	$111,751	General ledger

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule R, Part I, Identification of Disregarded Entities	Avera eCare, LLC was formed on June 2, 2017.
Schedule R, Part IV, related Organizations Taxable as a Corporation or	Trust Avera eCare was formed February 19, 2016 and dissolved June 2, 2017. The Corporation had no activity during its existence.