AVERA QUEEN OF PEACE: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- AVERA QUEEN OF PEACE (EIN 46-0224604)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201621339349303972
- Schema version
- 2014v6.0
- 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 H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T15:09:35-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460224604 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 6059952251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | William E Flett | PersonNm |
| Person Title | Sec/Treas & VP of Finance | PersonTitleTxt |
| Phone | 6059952251 | PhoneNum |
| Signature | 2016-05-12 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2016-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace Health Service | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Thomas A Clark | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster Street | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $108,574,088 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.averaqueenofpeace.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 969 | TotalEmployeeCnt |
| Total Volunteers | 57 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $865,066 | PYContributionsGrantsAmt |
| CY Contributions Grants | $283,044 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $99,738,113 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $106,176,795 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,920,627 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,600,903 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,191 | PYOtherRevenueAmt |
| CY Other Revenue | -$299,256 | CYOtherRevenueAmt |
| PY Total Revenue | $102,586,997 | PYTotalRevenueAmt |
| CY Total Revenue | $107,761,486 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $163,753 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,604,567 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,264,575 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,155,185 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $35,130 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $195,353 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,814,333 | PYOtherExpensesAmt |
| CY Other Expenses | $45,276,679 | CYOtherExpensesAmt |
| PY Total Expenses | $97,277,791 | PYTotalExpensesAmt |
| CY Total Expenses | $102,036,431 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,309,206 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,725,055 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $136,395,220 | TotalAssetsBOYAmt |
| Total Assets EOY | $142,177,140 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $45,965,069 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,060,314 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $90,430,151 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $94,116,826 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $85,345,651 | ExpenseAmt |
| Grant | $1,604,567 | GrantAmt |
| Revenue | $106,176,795 | RevenueAmt |
| Desc | Avera Queen of Peace's mission is to provide healthcare services to Mitchell, SD residents and the surrounding area. They provide acute care and long-term healthcare services, of which there were 7,941 acute patient days, 2,595 swing-bed patient days, 1,060 nursery patient days, 29,473 nursing home resident days, 8,872 assisted living resident days, and 2,190 independent living days. The breakout of these statistics per facility is as follows.Avera Queen of Peace Hospital7,518 Acute patient days1,918 Swing-bed patient days1,060 Newborn patient daysAvera Brady Health and Rehabilitation29,473 Long-term care resident days8,872 Assisted living days2,190 Independent living daysAvera Weskota Memorial Medical Center (CAH)337 Acute patient days348 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH)86 Acute patient days329 Swing-bed patient days Avera Queen of Peace maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $4,108,663.Avera Queen of Peace also provides community benefit health activities at less than or at no cost to support those in the area serviced. These activities include community education programs; special programs for the elderly, handicapped, and medically underserved; and a variety of broad community support activities. During the year ended June 30, 2015, specific activities include meals delivered to residential homes; meeting facilities; programs for patients and families suffering from cancer, diabetes, breathing disorders, and others; assistance to health educators; emergency healthcare providers and wellness programs.As a member of the Avera Health network, Avera Queen of Peace upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide a quality, effective health ministry and to improve the health care of individuals and our communities through a regionally integrated network of persons and institutions. Avera Queen of Peace engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. | Desc |
| Total Program Service Expenses | $85,345,651 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 132 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 969 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | William E Flett | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6059952251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 North Foster | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Terry Torgerson | ||||||||
| Chairperson | 2.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Diane Sandhoff | ||||||||
| Vice Chair | 2.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Loren Noess | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Charles Bergeleen | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Kathleen Crowley | ||||||||
| Board Member | 2.50 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| Gopal Vyas | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Bonita Gacnik | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| David Olson | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jacquelyn Johnson | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lori Essig | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jerry Thomsen | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sharry Knock | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Michael Krause DO | ||||||||
| Board Member/Physician | 7.50 | 0.00 | Yes (X) | $40,336 | $0 | $0 | ||
| Patricia Malters MD | ||||||||
| Board Member/Physician | 42.50 | 0.00 | Yes (X) | $243,147 | $0 | $25,280 | ||
| Greg Van Wald | ||||||||
| Board Member | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Joan Reichelt | ||||||||
| Board Member | 2.50 | 3.30 | Yes (X) | $0 | $0 | $0 | ||
| William Graham DOBoard Member | ||||||||
| Physician (thru Jan 31 2015) | 2.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Martin Christensen MDBoard | ||||||||
| Member/Physician (as of Feb 1, 2015) | 2.50 | 0.00 | Yes (X) | $500 | $0 | $0 | ||
| Thomas Clark | ||||||||
| President & CEO | 40.00 | 0.00 | Yes (X) | Yes (X) | $0 | $419,051 | $33,042 | |
| William E Flett | ||||||||
| Sec/Treas & VP of Finance | 40.00 | 0.00 | Yes (X) | $167,419 | $0 | $36,850 | ||
| Brian Kampmann MD | ||||||||
| Orthopedics, Sports Medici | 40.00 | 0.00 | $877,660 | $0 | $40,750 | Yes (X) | ||
| Anwarul Haq MD | ||||||||
| Hematology and Oncology | 40.00 | 0.00 | $639,041 | $0 | $21,724 | Yes (X) | ||
| Chris Krouse DO | ||||||||
| Orthopedics, Sports Medici | 40.00 | 0.00 | $995,415 | $0 | $39,550 | Yes (X) | ||
| Dileep Bhat MD | ||||||||
| Urology | 40.00 | 0.00 | $501,772 | $0 | $37,056 | Yes (X) | ||
| Dennis Leland MD FACS | ||||||||
| General Surgery | 40.00 | 0.00 | $481,031 | $0 | $43,328 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,946,321 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $419,051 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $277,580 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 57 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Health | |||||
| 3900 W Avera Drive Suite 300 | Sioux Falls | SD | 57108 | Shared Services | $7,735,662 |
| Journey Group Companies | |||||
| 800 South 7th Ave | Sioux Falls | SD | 57104 | Construction Services | $829,631 |
| Perspective Inc | |||||
| 196 E 6th St Ste 100 | Sioux Falls | SD | 57104 | Architectural | $590,965 |
| Puetz Corporation | |||||
| 800 N Kimball | Mitchell | SD | 57301 | Construction Services | $375,695 |
| Aegis Therapies Inc | |||||
| 1000 Fianna Way | Fort Smith | AR | 72919 | PT, OT & Speech Therapy Services | $365,614 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $235,583 | GovernmentGrantsAmt |
| All Other Contributions | $47,461 | AllOtherContributionsAmt |
| Total Contributions | $283,044 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient & Resident Services | 622110 | $102,989,449 | $102,989,449 |
| Other Revenue | 900099 | $1,842,704 | $1,842,704 |
| Meaningful Use Revenue | 900099 | $627,974 | $627,974 |
| Cafeteria | 900099 | $466,286 | $466,286 |
| Interest in Avera Health Fnd | 900099 | $135,256 | $135,256 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,126 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $115,126 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $106,176,795 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,547 | TotalRevenueColumnAmt |
| Exclusion | $32,547 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $343,813 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $706,788 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$362,975 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$362,975 | TotalRevenueColumnAmt |
| Exclusion | -$362,975 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,479,075 | SecuritiesAmt |
| Other | $194,906 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $105,625 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,479,075 | SecuritiesAmt |
| Other | $89,281 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,568,356 | TotalRevenueColumnAmt |
| Exclusion | $1,568,356 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $490 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $189 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $301 | TotalRevenueColumnAmt |
| Exclusion | $301 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Operating Interest | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $63,418 | TotalRevenueColumnAmt |
| Exclusion | $63,418 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $63,418 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $107,761,486 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $106,176,795 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,301,647 | 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 | $1,604,567 | TotalAmt |
| Program Services | $1,604,567 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,567 | TotalAmt |
| Program Services | $312,575 | ProgramServicesAmt |
| Management And General | $206,992 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,380 | TotalAmt |
| Program Services | $213,380 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,898,804 | TotalAmt |
| Program Services | $37,811,297 | ProgramServicesAmt |
| Management And General | $4,962,225 | ManagementAndGeneralAmt |
| Fundraising | $125,282 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,508,445 | TotalAmt |
| Program Services | $2,213,614 | ProgramServicesAmt |
| Management And General | $287,419 | ManagementAndGeneralAmt |
| Fundraising | $7,412 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,393,367 | TotalAmt |
| Program Services | $5,630,268 | ProgramServicesAmt |
| Management And General | $744,414 | ManagementAndGeneralAmt |
| Fundraising | $18,685 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,621,622 | TotalAmt |
| Program Services | $2,304,668 | ProgramServicesAmt |
| Management And General | $309,351 | ManagementAndGeneralAmt |
| Fundraising | $7,603 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,519 | TotalAmt |
| Program Services | $258,519 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530 | TotalAmt |
| Program Services | $530 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,903,532 | TotalAmt |
| Program Services | $4,990,137 | ProgramServicesAmt |
| Management And General | $6,906,567 | ManagementAndGeneralAmt |
| Fundraising | $6,828 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,752 | TotalAmt |
| Program Services | $20,998 | ProgramServicesAmt |
| Management And General | $8,754 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,036,850 | TotalAmt |
| Program Services | $6,335,003 | ProgramServicesAmt |
| Management And General | $1,674,719 | ManagementAndGeneralAmt |
| Fundraising | $27,128 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,356 | TotalAmt |
| Program Services | $153,457 | ProgramServicesAmt |
| Management And General | $112,899 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000,451 | TotalAmt |
| Program Services | $1,421,131 | ProgramServicesAmt |
| Management And General | $579,320 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,725 | TotalAmt |
| Program Services | $207,458 | ProgramServicesAmt |
| Management And General | $61,484 | ManagementAndGeneralAmt |
| Fundraising | $1,783 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,209 | TotalAmt |
| Program Services | $60,882 | ProgramServicesAmt |
| Management And General | $60,892 | ManagementAndGeneralAmt |
| Fundraising | $435 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,506 | TotalAmt |
| Program Services | $552,506 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,103,066 | TotalAmt |
| Program Services | $4,103,066 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750,555 | TotalAmt |
| Program Services | $750,555 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $11,041,820 | $11,041,820 | |
| Bad Debt Expense | $5,105,233 | $5,105,233 | |
| Equipment Lease and Ren | $44,389 | $34,123 | $10,266 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $790,186 | TotalAmt |
| Program Services | $219,864 | ProgramServicesAmt |
| Management And General | $570,125 | ManagementAndGeneralAmt |
| Fundraising | $197 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,036,431 | TotalAmt |
| Program Services | $85,345,651 | ProgramServicesAmt |
| Management And General | $16,495,427 | ManagementAndGeneralAmt |
| Fundraising | $195,353 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,243,794 | BOYAmt |
| EOY | $4,498,284 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,708,790 | BOYAmt |
| EOY | $13,125,887 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,402,519 | BOYAmt |
| EOY | $1,425,877 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,342,808 | BOYAmt |
| EOY | $1,496,103 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $109,735,397 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $61,063,491 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,284,000 | BOYAmt |
| EOY | $48,671,906 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $959,046 | BOYAmt |
| EOY | $966,799 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,788,645 | BOYAmt |
| EOY | $59,440,525 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,356,132 | BOYAmt |
| EOY | $1,665,495 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,142,822 | BOYAmt |
| EOY | $1,785,026 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,166,664 | BOYAmt |
| EOY | $9,101,238 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,395,220 | BOYAmt |
| EOY | $142,177,140 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,533,002 | BOYAmt |
| EOY | $10,497,229 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,274 | BOYAmt |
| EOY | $71,908 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,799,553 | BOYAmt |
| EOY | $35,433,963 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,359 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,527,240 | BOYAmt |
| EOY | $2,050,855 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,965,069 | BOYAmt |
| EOY | $48,060,314 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,085,253 | BOYAmt |
| EOY | $90,773,261 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,543,121 | BOYAmt |
| EOY | $2,539,692 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,777 | BOYAmt |
| EOY | $803,873 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,430,151 | BOYAmt |
| EOY | $94,116,826 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,395,220 | BOYAmt |
| EOY | $142,177,140 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,725,055 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$981,064 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,057,316 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $9,278 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,278 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Avera Queen of Peace Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,681,098 | BeginningYearBalanceAmt |
| Contributions | $326,197 | ContributionsAmt |
| Investment Earnings Or Losses | $95,588 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $222,117 | OtherExpendituresAmt |
| Administrative Expenses | $21,042 | AdministrativeExpensesAmt |
| End Year Balance | $2,859,724 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,065,019 | BeginningYearBalanceAmt |
| Contributions | $1,990,675 | ContributionsAmt |
| Investment Earnings Or Losses | $117,527 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $473,098 | OtherExpendituresAmt |
| Administrative Expenses | $19,025 | AdministrativeExpensesAmt |
| End Year Balance | $2,681,098 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,040,814 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $24,205 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,065,019 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,034,190 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,624 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,040,814 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $793,583 | BeginningYearBalanceAmt |
| Contributions | $109,334 | ContributionsAmt |
| Investment Earnings Or Losses | $131,273 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,034,190 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.21000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.09000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.70000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,002,970 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,908,464 | OtherCostOrOtherBasisAmt |
| Book Value | $3,911,434 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,341,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,739,901 | DepreciationAmt |
| Book Value | $26,601,564 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,871,923 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,047,298 | DepreciationAmt |
| Book Value | $7,824,625 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,610,575 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,276,292 | DepreciationAmt |
| Book Value | $10,334,283 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,671,906 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Investment in affiliated organizations | $420,869 | C |
| Interest in Avera Health Foundation | $3,144,402 | F |
| Interest in net assets of Mabee Trust | $838,780 | F |
| Assets Limited to use - Avera Pooled Investments | $55,036,474 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $59,440,525 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from related parties | $973,542 |
| Custodial funds held by related party | $8,127,696 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,101,238 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Derivative liability | $1,965,855 |
| Estimated third-party payor settlements | $85,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,050,855 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The Organization holds funds in trust on behalf of its residents. |
| Part V, Line 4: | The organization's endowments consist of a portion of their interest in the net assets of Avera Health Foundation and their beneficial interest in the Mabee Trust. Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The endowment fund assets included in the Organization's beneficial interest in the Mabee Trust have been established to purchase equipment and furnishings for the Organization. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. The Organization currently does not have any board-designated endowment funds. |
| 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 for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2012. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3313 | PersonsServedCnt |
| Total Community Benefit Expns | $1,410,763 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,410,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7677 | PersonsServedCnt |
| Total Community Benefit Expns | $8,298,055 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,038,921 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,259,134 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02330 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10990 | PersonsServedCnt |
| Total Community Benefit Expns | $9,708,818 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,038,921 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,669,897 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 90 | PersonsServedCnt |
| Total Community Benefit Expns | $4,974 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $120 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $55,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $55,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 6787 | PersonsServedCnt |
| Total Community Benefit Expns | $1,051,090 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $792,591 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $258,499 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,726,781 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,726,781 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01780 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 29 | ActivitiesOrProgramsCnt |
| Persons Served | 6877 | PersonsServedCnt |
| Total Community Benefit Expns | $2,837,845 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $792,711 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,045,134 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02120 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 29 | ActivitiesOrProgramsCnt |
| Persons Served | 17867 | PersonsServedCnt |
| Total Community Benefit Expns | $12,546,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,831,632 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,715,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05910 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 250 | PersonsServedCnt |
| Total Community Benefit Expns | $200 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $200 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $82,545 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $57,044 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,501 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $5,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 250 | PersonsServedCnt |
| Total Community Benefit Expns | $88,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $57,044 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,201 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,105,233 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $32,620,543 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,077,728 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,457,185 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 3 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (3 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | |||||||||||
| 1 | 525 North Foster Street | Mitchell | SD | 57301 | www.averaqueenofpeace.org | 10552 | Yes (X) | Yes (X) | Yes (X) | 5 Provider Based Clinics | |
| Avera Weskota Memorial Medical Center | |||||||||||
| 2 | 609 1st Street NE | Wessington Springs | SD | 57382 | www.avera.org/weskota | 48209 | Yes (X) | Yes (X) | Yes (X) | ||
| Avera De Smet Memorial Hospital | |||||||||||
| 3 | 306 Prairie Avenue SW | De Smet | SD | 57231 | www.avera.org/de-smet | 50726 | Yes (X) | Yes (X) | Yes (X) | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Other WebsiteOtherWebsiteInd | Other Website URLOtherWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Strategy AttachedStrategyAttachedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP Notice DisplayedFAPNoticeDisplayedInd | Communtity Notified FAPCommuntityNotifiedFAPInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd | FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Average Negotiated RatesAverageNegotiatedRatesInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Queen of Peace Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | www.avera.org/queen-of-peace | Yes (X) | www.avera.org | Yes (X) | Yes (1) | 12 | Yes (1) | see Part V | 0 | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. | Yes (X) | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A | Yes (X) | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) |
| Avera Weskota Memorial Medical Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | www.avera.org/weskota/ | Yes (X) | www.avera.org | Yes (X) | Yes (1) | 12 | Yes (1) | See Part V | 0 | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. | Yes (X) | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A | Yes (X) | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) |
| Avera De Smet Memorial Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 3 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | www.avera.org/de-smet/ | Yes (X) | www.avera.org | Yes (X) | Yes (1) | 12 | Yes (1) | See Part V | 0 | 0 | Yes (1) | Yes (X) | 150.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. | Yes (X) | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A | Yes (X) | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) |
Supplemental Information SupplementalInformationGrp (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Avera Queen of Peace Hospital | Part V, Section B, Line 5: Six focus groups were held to collect primary data from community leaders, senior citizens, single parents, small business representatives, large business representatives, and post-secondary students. In addition, the following individuals were consulted in conducting the needs assessment: Principal, Longfellow Elementary School; Director of Adult Services and Aging, Davison County; Public Health Nurse, Davison County; Director of Family Planning, Davison County; and Parish Health Nurse, First Lutheran Church. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 5: Avera Weskota Memorial Hospital gathered both secondary and primary data for the assessment. A Community Development Specialist with the Planning and Development District gathered primary data by conducting focus groups and a number of key informant interviews. Avera Weskota also collected primary data through a survey tool. The survey was utilized to reach the broader community and was distributed to the following four groups of people throughout the Wessington Springs area: 1) community & county members 2) health care providers, staff & board members 3) uninsured/underinsured populations & 4) community leaders. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 5: Input was gathered from individuals representing the following groups: Public Safety, Healthcare, Low income, Contractors/self employed, schools, SD Dept of Health Office of Rural Health |
| Avera Queen of Peace Hospital | Part V, Section B, Line 11: Behavioral Health Services: Avera Queen of Peace has been involved with Avera Health in the establishment of Service Lines. The Service Line model is a systematic approach to integrating appropriate levels of care with system-wide resources. Regardless of a patient's geographical or clinical location and using existing resources within the system, the service line model insures patients have access to the care they need, where they need it. The model reduces unnecessary duplication of resources and increases opportunities to access services that would otherwise be unavailable in a facility or region due to limitations such as geography, utilization and affordability. Launched in 2012, Behavioral Health Services was the first Service Line established within Avera. The Behavioral Health Service Line Steering Team has identified long-term viability for support of a clinical psychologist and a psychiatrist within the Avera Queen of Peace Region. Avera Queen of Peace hired a clinical psychologist within a local Avera Medical Group primary care clinic in February 2014. Disease Prevention and Wellness: Avera Queen of Peace currently offers several educational and wellness initiatives to the community. These initiatives come in the form of support groups, fitness incentives, fitness classes, nutrition education, demonstrations (i.e. cooking demos), etc. While Avera Queen of Peace will continue to offer these programs, it will pursue additional partnering within the community, including deeper dialogue with public health agencies serving the area. The intention is to establish efficient and efficacious partnerships and programming that reaches those most in need, including youth and young adults. Avera Queen of Peace has developed strong partnerships with Dakota Wesleyan University, the Mitchell Recreation Center and Mitchell High School. The first activity has been to increase and organize the resources and programming across the community in the areas of athletic training, sports medicine and sports performance. One anticipated benefit of these partnerships is better utilization and less duplication of current resources.In January 2014 Avera Queen of Peace committed $2.5 million towards a joint-use sports and community wellness complex on the Dakota Wesleyan University Campus. Ground was broken for the Avera/DWU Sports and Wellness facility in September 2014 and is anticipated to be completed in February 2016.Primary Care Access: Avera Queen of Peace is actively recruiting both family practice and internal medicine physicians. To date a family practice physician, three emergency medicine physicians, a part-time pediatrician, and fellowship-trained sports medicine physician have begun practices. Fiscal year 2016 physician recruitments include two pediatricians, a urologist, a medical oncologist and two obstetrician/gynecologists. Fiscal year 2017 physician recruitments include an internal medicine physician, pediatrician and dermatologist.In August 2014, Avera Queen of Peace started construction of a 70,000 square foot medical office and outpatient building to house family medicine, internal medicine, pediatrics, general surgery, urology, dialysis, laboratory, radiology and dialysis services. The location of the clinic will be near Interstate 90 with easier access for patients travelling from outside the city limits. The facility will place many of Avera Medical Group practices under one roof, in a location that is more visible and accessible than current locations and nearer to a portion of the economically poor in the community. Construction of this facility is anticipated to be completed in March 2016.Items not being addressed:Adequate and Affordable housing: Avera Queen of Peace currently has representation on the Mitchell Development Corporation. The Mitchell Development Corporation is active in attracting investment in affordable housing.Affordable dental care: A mobile dental care clinic currently assists local dentists in providing free dental services to needy children. Our findings of patients who are unable to find a dentist with available appointments or willing to accept uninsured patients will be communicated with dentists. Affordable and reliable public transportation: The City of Mitchell currently operates a public transit system; additionally, a local company also provides transportation services. Our findings of wait times for transportation have been communicated with transportation providers. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 11: Poor Nutrition Among Youth: A clinical staff member serves on the Wessington Springs School Strategic Plan nutrition subgroup. Recommendations are made related to nutrition for the students. Changes in menus have occurred. Vegetables and fruits are supplied to the children for an afternoon snack.Lack of Assisted Living Housing: This finding was reported to the local Nursing Home Board of Directors to address in their strategic planning as they currently provide independent senior housing and may be able to add or convert space for assisted living.Smoking:*Marketed Freedom From Smoking sessions offered at AQOP to Wessington Springs community members 10/22/12. *Offered SD Quit Line information and other smoking cessation information at Health and Education Committee booth Wessington Springs Farm and Home Show, February 2013 and February 14. Perceived lack of healthcare services*Worked in cooperation with Jerauld County Health Services Clinic to identify services offered on campus. *Presented a program for the public at Wessington Springs Farm and Home Show highlighting the services offered.*Ads in newspaper highlighting physical therapy services *Programs at Springs Area Community Club highlighting various departments and services Perceived high incidence of cancer*Annual Fourth of July Walk and Run for Wellness with funds going to support Heart and Sole Cancer Fund *Information made available regarding cancer rates at Walk and Run and Farm and Home Show. *Provide corporate sponsorship to American Cancer Society's Jerauld-Sanborn Relay for Life events. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 11: Hospital to address two priorities:Specialty Physicians: ADMH worked with the Medical Staff to identify needs. Established outreach services for two surgeons - General and Orthopedic Surgeon. Maintained telemedicine services of 19 medical doctors in a variety of specialties. Cancer: ADMH offered yearly mini health fair and heart health which included a variety of screenings including but not limited to skin cancer and education on breast and colorectal cancer.Due to limited financial, physical space and time limitations, the interdisciplinary CHNA team did not prioritize/assign for implementation at this time:Water Quality: All comments and concerns will be addressed by the City of De Smet.Physical Activity: The City of De Smet is addressing the wellness needs of the community with plans for construction of a Community Center and Wellness Center.Domestic Abuse: This need will be addressed by the Brookings Abuse Shelter Rural Outrach Program as this program is best qualified to address this need. |
| Avera Queen of Peace Hospital | Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Queen of Peace Hospital | Part V, Section B, Line 24: Individuals eligible for financial assistance are not charged gross charges for emergency or other medically necessary care; however may be charged gross charges for elective care. |
| Avera Weskota Memorial Medical Center | Part V, Section B, Line 24: Individuals eligible for financial assistance are not charged gross charges for emergency or other medically necessary care; however may be charged gross charges for elective care. |
| Avera De Smet Memorial Hospital | Part V, Section B, Line 24: Individuals eligible for financial assistance are not charged gross charges for emergency or other medically necessary care; however may be charged gross charges for elective care. |
| Part V, Section B, Line 10a | The most recently adopted implementation strategy for each of the facilities has been posted to the following website:http://www.avera.org/experience/shared/community-needs-health-assessments/ |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Avera Queen of Peace Hospital Part V, Section B, line 16a website: | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. |
| Avera Queen of Peace Hospital Part V, Section B, line 16b website: | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A |
| Avera Queen of Peace Hospital Part V, Section B, line 16c website: | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance |
| Avera Weskota Memorial Medical Center Part V, Section B, line 16a website: | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. |
| Avera Weskota Memorial Medical Center Part V, Section B, line 16b website: | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A |
| Avera Weskota Memorial Medical Center Part V, Section B, line 16c website: | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance |
| Avera De Smet Memorial Hospital Part V, Section B, line 16a website: | http://www.avera.org/app/files/public/4735/avera-financial-assistance-corp. |
| Avera De Smet Memorial Hospital Part V, Section B, line 16b website: | http://www.avera.org/app/files/public/4732/pdf-avera-corp-Avera-Financial-A |
| Avera De Smet Memorial Hospital Part V, Section B, line 16c website: | http://www.avera.org/app/files/public/52352/Summary-of-Financial-Assistance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Avera Brady Health and Rehab | ||||
| 500 S Ohman St | Mitchell | SD | 57301 | Nursing Home |
| Avera Brady Assisted Living | ||||
| 1414 W Cedar Ave | Mitchell | SD | 57301 | Assisted Living |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | A combination of income and assets test is utilized to determine eligibility for free or discounted care. Points are assigned based on income as a percentage of FPG and net assets owned with points deducted for ongoing medical expenses such as drugs. Patients with the fewest points receive the largest discount. 0-1 points receive 100% discount on bills while remaining discounts range from 10-90% depending on point totals and dollar amount of charges. |
| Part I, Line 6a: | Our community benefit report is contained in a report prepared by Avera Health, a related organization. It is available through the website and requested mailing, and is filed with the Catholic Health Association. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind donations, line 7i were compiled using actual costs recorded in the CBISA software. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. |
| Part I, Ln 7 Col(f): | Avera Queen of Peace bad debt expense of $5,105,233 is included on Form 990, Part IX, Line 25, Column (A) but excluded for purposes of calculating this percentage. |
| Part II, Community Building Activities: | Avera Queen of Peace supports numerous economic development organizations with participation at meetings and donations throughout its service area. Additionally, Avera Queen of Peace works with Dakota Wesleyan University, the Mitchell Technical Institute, and local high schools to address healthcare worker shortages in the communities of its service area. Avera Queen of Peace also partners with the Mitchell Senior Meals program to ensure access to nutritious meals for the elderly. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 10 of the attached audited financial statements. |
| Part III, Line 8: | Medicare allowable costs of care are based on the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Avera Queen of Peace follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community. |
| Part III, Line 9b: | If the patient qualifies for the Organization's financial assistance policy for low-income, uninsured patients and is cooperating with the Organization with regard to efforts to settle an outstanding bill within a reasonable time period, the Organization or its agent shall not send, nor indicate that it will send, the unpaid bill to any outside agency if doing so may negatively impact a patient's credit. At such time as the organization sends the uncollected account to an outside collection agency, the amount referred to the agency shall reflect the reduced-payment level for which the patient was eligible under the Organization's financial assistance policy for low-income uninsured patients. Any extended payment plans offered by a hospital in settling the outstanding bills of low income, uninsured patients who qualify for financial assistance shall be interest-free so long as the repayment schedule is met. |
| Part VI, Line 2: | Avera Queen of Peace conducted a Community Health Needs Assessment for each facility during 2012 and 2013. The CHNA Implementation Plans for Avera Weskota Memorial Medical Center and Avera De Smet Memorial Hospital were adopted by the Avera Queen of Peace Governing Board on May 28, 2013. The CHNA implementation plan for Avera Queen of Peace Hospital was adopted by the Avera Queen of Peace Governing Board on June 25, 2013. |
| Part VI, Line 3: | A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and is included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Part VI, Line 4: | Avera Queen of Peace's service area includes Davison County and surrounding counties in South Dakota. In 2013, the population for Davison County was estimated to be 19,823. Approximately 17.2% of the population is age 65 or older. The average per capita income is $24,597 and approximately 12.2% of individuals are below the federal poverty level. The nearest like hospital in the area is approximately 72 miles from Avera Queen of Peace. |
| Part VI, Line 5: | Avera Queen of Peace is a verified Level II trauma center and operates an emergency department staffed 24 hours per day with board certified physicians. Emergency care is provided on an open door basis regardless of ability to pay. Avera Queen of Peace leases two critical access hospitals which provide a broad range of inpatient, outpatient services and 24 hour emergency rooms in two very rural communities.Avera Queen of Peace owns three rural health clinics which provide primary care services in three rural communities.Similar to the hospitals in the Avera Queen of Peace region, the clinics are operated on an open door basis and care is provided regardless of ability to pay.Medical staff privileges are extended to all licensed and qualified applicants. The Avera Queen of Peace Board of Directors is principally comprised of community members from the primary and secondary services areas. Members come from a variety of backgrounds including banking, education, agriculture, healthcare and private industry. |
| Part VI, Line 6: | The communities in which Avera operates all have unique health and community benefit needs and in keeping with the Catholic Healthcare Association guidelines each hospital strives to meet its community's identified needs. The Avera central office advocates for all on community benefit related matters of state, regional and national importance. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Dakota Wesleyan University | |||||||
| 1200 W University Ave | Mitchell | SD | 57301 | 460224589 | 501(c)(3) | $1,504,000 | Donation |
| De Smet Community Foundation | |||||||
| PO Box 42 | De Smet | SD | 57231 | 461401425 | 501(c)(3) | $25,000 | Donation |
| Mitchell Tech Institution Foundation | |||||||
| 1800 E Spruce St | Mitchell | SD | 57301 | 460452950 | 501(c)(3) | $10,000 | Donation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization only makes grants to other organizations which are tax-exempt under Section 501(c)(3). | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patricia Malters MD | ||||||||||||||
| Board Member/Physician | $227,887 | $0 | $11,000 | $0 | $4,260 | $0 | $19,112 | $0 | $6,671 | $0 | $268,930 | $0 | $0 | $0 |
| Thomas Clark | ||||||||||||||
| President & CEO | $0 | $333,797 | $0 | $0 | $0 | $85,254 | $0 | $11,306 | $0 | $22,443 | $0 | $452,800 | $0 | $0 |
| William E Flett | ||||||||||||||
| Sec/Treas & VP of Finance | $166,587 | $0 | $180 | $0 | $652 | $0 | $14,022 | $0 | $23,228 | $0 | $204,669 | $0 | $0 | $0 |
| Brian Kampmann MD | ||||||||||||||
| Orthopedics, Sports Medici | $700,695 | $0 | $174,117 | $0 | $2,848 | $0 | $20,422 | $0 | $21,858 | $0 | $919,940 | $0 | $0 | $0 |
| Anwarul Haq MD | ||||||||||||||
| Hematology and Oncology | $549,530 | $0 | $12,500 | $0 | $77,011 | $0 | $20,500 | $0 | $2,478 | $0 | $662,019 | $0 | $0 | $0 |
| Chris Krouse DO | ||||||||||||||
| Orthopedics, Sports Medici | $966,498 | $0 | $24,000 | $0 | $4,917 | $0 | $20,422 | $0 | $20,724 | $0 | $1,036,561 | $0 | $0 | $0 |
| Dileep Bhat MD | ||||||||||||||
| Urology | $423,872 | $0 | $36,250 | $0 | $41,650 | $0 | $20,500 | $0 | $16,894 | $0 | $539,166 | $0 | $0 | $0 |
| Dennis Leland MD FACS | ||||||||||||||
| General Surgery | $445,017 | $0 | $30,000 | $0 | $6,014 | $0 | $20,500 | $0 | $23,862 | $0 | $525,393 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I Line 3: | FormAndLineReferenceDesc |
| Explanation | The President/CEO's compensation is paid by a related organization, Avera Health. Avera Queen of Peace relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| David Malters MD | |||
| Family member of board member | $182,244 | Compensation | 0 |
| Andrea Malters | |||
| Family member of board member | $31,137 | Compensation | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Added Avera Medical Group Internal Medicine Olegario Clinic, October 2014 Added Integrated Therapy Services, LLC, November 2014 Added Advanced Physical Therapy, May 2015 |
| Form 990, Part III, line 3 | Hospitality House ceased operations during the fiscal year ending 06/30/15. |
| Form 990, Part VI, Section A, line 2 | Sister Kathleen Crowley has a business relationship with Thomas Clark. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Avera Health has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. |
| Form 990, Part VI, Section A, line 8b | Avera Queen of Peace Hospital does not have committees with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11 | The return is reviewed initially by the CFO. The return is made available to the Board of Directors for review 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 15b | The CEO is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. The compensation of the VP of Finance is determined by Human Resources based on a market analysis of comparable positions. The compensation is approved by the CEO. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents and conflict of interest policy are not available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public. |
| Form 990, Part IX, line 11g | Recruitment: Program service expenses 113,355. Management and general expenses 39,317. Fundraising expenses 0. Total expenses 152,672. Repairs and Maintenance: Program service expenses 1,398,735. Management and general expenses 40,137. Fundraising expenses 0. Total expenses 1,438,872. Purchased Services: Program service expenses 2,659,947. Management and general expenses 533,958. Fundraising expenses 6,828. Total expenses 3,200,733. ACS Fees: Program service expenses 818,100. Management and general expenses 6,293,155. Fundraising expenses 0. Total expenses 7,111,255. |
| Form 990, Part XI, line 9: | Change in Fair Value of Interest Rate Swap 44,985. Equity Transfers -1,102,301. |
| Form 990, Part XII, Line 2c: | The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements of Avera Health, which includes Avera Queen of Peace. |
| Form 990, Part VI, Section B, Line 16b: | There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. |
| Form 990, Part X, Line 20: | The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, and Avera Sacred Heart. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673). |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Integrated Therapy Services LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 N Foster St | AddressLine1Txt |
| City | Mitchell | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320450803 | EIN |
| Primary Activities | Physical, Occupational, and Speech Therapy | PrimaryActivitiesTxt |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Total Income | $548,368 | TotalIncomeAmt |
| End Of Year Assets | $926,009 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Queen of Peace | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 West Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of Health | SD | 501(c)(3) | Line 9 | N/A | 0 | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera St Anthony's Hospital | |||||||||||
| 300 N 2nd Street | ONeill | NE | 68763 | 470463911 | Healthcare Education | NE | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Holy Family | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare Services | IA | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Holy Family Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Fundraising | IA | 501(c)(3) | Line 9 | 0 | Avera Holy Family | |
| Avera Marshall | |||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 410919153 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Marshall Foundation | |||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 411784801 | Fundraising | MN | 501(c)(3) | Line 7 | 0 | Avera Marshall | |
| St Benedict Health Center | |||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| St Benedict Health Center Foundation | |||||||||||
| West Glynn Drive PO Box B | Parkston | SD | 57366 | 460458725 | Support Health Related Services | SD | 501(c)(3) | Line 11a, I | 0 | St Benedict Health Center | |
| Avera McKennan | |||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460224743 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Mary's | |||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera at Home | |||||||||||
| 5116 S Solberg Ave | Sioux Falls | SD | 57108 | 460399291 | Home Services | SD | 501(c)(3) | Line 9 | 0 | Avera Health | |
| Lewis and Clark Health Education and Service Agency | |||||||||||
| 1000 W 4th Street Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare Education | SD | 501(c)(3) | Line 9 | 0 | Sacred Heart Health Services | |
| Avera St Luke's | |||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Q & M Properties LLC | ||||||||||||||
| 525 North Foster | Mitchell | SD | 57301 | 731652049 | Medical clinic building | SD | Avera Queen of Peace | Related | -$509 | $367,501 | 0 | Yes (1) | 0.50000 | |
| Avera Home Medical Equipment LLC | ||||||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460488198 | Medical services - home medical equipment | SD | N/A | |||||||
| Home Medical Equipment of Pierre LLC | ||||||||||||||
| 329 E Dakota | Pierre | SD | 57501 | 460444002 | Medical services - home medical equipment | SD | N/A | |||||||
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | ||||||||||||||
| 714 Lincoln St NE | Lemars | IA | 51031 | 820582350 | Medical services - home medical equipment | SD | N/A | |||||||
| Avera Home Medical Equipment of Estherville LLC | ||||||||||||||
| PO Box 5045 | Sioux Falls | SD | 57117 | 201686097 | medical services - home medical equipment | SD | N/A | |||||||
| Avera Home Medical Equipment of Sioux Center LLC | ||||||||||||||
| 38 19th ST SW | Sioux Center | IA | 51250 | 753203100 | medical services - home medical equipment | SD | N/A | |||||||
| Avera Home Medical Equipment of Marshall LLC | ||||||||||||||
| 1104 East College Drive | Marshall | MN | 56258 | 205271924 | medical services - home medical equipment | SD | N/A | |||||||
| Avera Home Medical Equipment of Spencer Hospital LLC | ||||||||||||||
| 2400 S Minnesota Ave 102 | Sioux Falls | SD | 57117 | 800619999 | medical services - home medical equipment | SD | N/A | |||||||
| Surgical Associates Endoscopy Clinic LLC | ||||||||||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | surgical associates | SD | N/A | |||||||
| Heart Hospital of South Dakota LLC | ||||||||||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | healthcare services | SD | N/A | |||||||
| Brookings Health System - Avera HME LLC | ||||||||||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A | |||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | |||||||||||||
| 5132 S Cliff Ave Suite 101 | Sioux Falls | SD | 57108 | 460373021 | collection agency | SD | N/A | C | 0 | ||||
| Avera Health Plans Inc | |||||||||||||
| 3900 West Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | health financing and health plan administration | SD | N/A | C | 0 | ||||
| Avera Property Insurance Inc | |||||||||||||
| 610 W 23rd St Ste 1 PO Box 38 | Yankton | SD | 57078 | 460463155 | insurance | SD | N/A | C | 0 | ||||
| Dr Donald & Marguerite Mabee Trust | |||||||||||||
| c/o First National Bank of South Da | Mitchell | SD | 57301 | 466056202 | investing | SD | T | Yes (1) | Avera Queen of Peace Hospital | $18,143 | $838,780 | 1.00000 | |
| Valley Health Services | |||||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | rental real estate | SD | N/A | C | 0 | ||||
| Alucent Medical Inc | |||||||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | biotech research | SD | N/A | C | 0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Avera McKennan | ||
| L | $1,014,500 | General Ledger |
| Avera Home | ||
| L | $50,886 | General Ledger |
| Avera St Luke's | ||
| M | $129,636 | General Ledger |