SACRED HEART HEALTH SERVICES: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: SACRED HEART HEALTH SERVICES (EIN 46-0225483)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-15
IRS object ID: 201521359349304637
Schema version: 2013v4.0
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 G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-15T12:56:19-05:00	ReturnTs
Tax Period End	2014-06-30	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	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	800 NICOLLET MALL STE 1300	AddressLine1
City	MINNEAPOLIS	City
State	MN	State
ZIP Code	554027033	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460225483	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SACRED HEART HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	SACR	BusinessNameControlTxt
Phone	6056688000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT STREET	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DOUGLAS R EKEREN	PersonNm
Person Title	PRESIDENT & CEO	PersonTitleTxt
Phone	6056688000	PhoneNum
Signature	2015-05-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KIM HUNWARDSEN CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2015-05-13	PreparationDt

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	AVERA SACRED HEART HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Principal Officer	DOUGLAS R EKEREN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT STREET	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$118,513,012	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AVERASACREDHEART.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1911	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	PROMOTION OF HEALTH	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	1268	TotalEmployeeCnt
Total Volunteers	355	TotalVolunteersCnt
Total Gross UBI	$16,916	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,019,750	PYContributionsGrantsAmt
CY Contributions Grants	$667,563	CYContributionsGrantsAmt
PY Program Service Revenue	$102,558,568	PYProgramServiceRevenueAmt
CY Program Service Revenue	$109,377,521	CYProgramServiceRevenueAmt
PY Investment Income	$6,570,874	PYInvestmentIncomeAmt
CY Investment Income	$8,040,496	CYInvestmentIncomeAmt
PY Other Revenue	-$412,272	PYOtherRevenueAmt
CY Other Revenue	-$790,951	CYOtherRevenueAmt
PY Total Revenue	$110,736,920	PYTotalRevenueAmt
CY Total Revenue	$117,294,629	CYTotalRevenueAmt
PY Grants And Similar Paid	$147,429	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$195,581	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$55,059,477	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$54,376,511	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$19,195	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$159,655	CYTotalFundraisingExpenseAmt
PY Other Expenses	$46,722,976	PYOtherExpensesAmt
CY Other Expenses	$52,034,393	CYOtherExpensesAmt
PY Total Expenses	$101,929,882	PYTotalExpensesAmt
CY Total Expenses	$106,625,680	CYTotalExpensesAmt
PY Revenues Less Expenses	$8,807,038	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$10,668,949	CYRevenuesLessExpensesAmt
Total Assets BOY	$256,656,790	TotalAssetsBOYAmt
Total Assets EOY	$287,231,478	TotalAssetsEOYAmt
Total Liabilities BOY	$38,162,313	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$44,761,449	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$218,494,477	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$242,470,029	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	AVERA IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$86,845,134	ExpenseAmt
Grant	$195,581	GrantAmt
Revenue	$109,377,521	RevenueAmt
Desc	AVERA SACRED HEART HOSPITAL (SACRED HEART HEALTH SERVICES) LEADS DELIVERY OF HEALTHCARE TO ITS REGION THROUGH OVER 1,000 EMPLOYEES (AS WELL AS 58 PHYSICIANS ON ITS ACTIVE MEDICAL STAFF) WHO COORDINATE CARE TO DELIVER PATIENT CARE AS AN INTEGRATED UNIT. AVERA SACRED HEART AND ITS AFFILIATES (REFERRED TO COLLECTIVELY AS SACRED HEART HEALTH SERVICES) ALSO WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE IN SOUTHEAST SOUTH DAKOTA AND NORTHEAST NEBRASKA. IN ADDITION TO THE 144 BED HOSPITAL, AVERA SACRED HEART INCLUDES TWO NURSING HOMES AND A CONGREGATE HOUSING FACILITY, A 23-BED CRITICAL ACCESS HOSPITAL, LONG-TERM CARE FACILITY, AND 2 CLINICS IN CREIGHTON, NE. IT ALSO MANAGES THREE HOSPITALS AND TWO NURSING HOMES. AVERA SACRED HEART OPERATES UNDER THE TENETS OF THE ROMAN CATHOLIC CHURCH AND IN ACCORDANCE WITH THE PHILOSOPHY AND VALUES ESTABLISHED FOR AVERA HEALTH, A SPONSORED HEALTH MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS. AVERA SACRED HEART ENGAGES IN ACTIVITIES DESIGNED TO IMPROVE THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES THAT IT SERVES IN RESPONSE TO A CALLING TO HEAL THE SICK, THE ELDERLY AND THE OPPRESSED.REQUIREMENTS OF THE IRS COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT ORGANIZATIONS ARE INTEGRAL TO AVERA SACRED HEART HOSPITAL'S LARGER CHARITABLE MISSION OF IMPROVING HEALTH AND QUALITY OF LIFE. SPECIFICALLY, AVERA SACRED HEART IS GOVERNED BY AN INDEPENDENT BOARD INCLUDING COMMUNITY LEADERS, BUSINESS AND CLINICAL HEALTHCARE EXPERTS. THE BOARD HAS A HISTORY OF COMMITMENT TO ACT WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES FOR THE BENEFIT OF THE COMMUNITY. * SACRED HEART HEALTH SERVICES MAKES MEDICAL CARE ACCESSIBLE TO THE COMMUNITIES IT SERVES REGARDLESS OF ABILITY TO PAY, OF WHICH THERE WERE 13,398 HOSPITAL PATIENT DAYS AND 82,855 NURSING HOME RESIDENT DAYS IN FISCAL YEAR 2014. AVERA SACRED HEART HOSPITAL WAS NAMED BY HEALTHGRADES AS ONE OF THE TOP 2% HOSPITALS IN THE NATION FOR PROVIDING AN OUTSTANDING PATIENT EXPERIENCE, SEVEN YEARS IN A ROW, AND PATIENT SAFETY EXCELLENCE. THE HOSPITAL RECEIVED A THREE-YEAR ACCREDITATION FROM THE JOINT COMMISSION WITH "TOP PERFORMER FOR KEY QUALITY MEASURES."THE AVERA SACRED HEART HOSPITAL DIALYSIS UNIT WAS RECOGNIZED AS A 5-DIAMOND PATIENT SAFETY FACILITY. AVERA SISTER JAMES CARE CENTER AND AVERA YANKTON CARE CENTER WERE RECOGNIZED AS FIVE-YEAR RECIPIENTS OF THE EXCELLENCE IN ACTION AWARD BY MY INNERVIEW. AVERA CANCER INSTITUTE YANKTON ALSO RECEIVED A FULL FROM THE AMERICAN COLLEGE OF SURGEONS WITH A COMMENDATION SILVER LEVEL AWARD (5 COMMENDATIONS OUT OF A POSSIBLE 7). SACRED HEART HEALTH SERVICES OPERATES 2 FULL-TIME EMERGENCY DEPARTMENTS, ONE IN YANKTON AND ONE IN CREIGHTON, NEBRASKA, WHICH PROVIDE EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. IN FISCAL YEAR 2014, THERE WERE 10,262 VISITS. AVERA SACRED HEART PROVIDES CLINICAL SERVICES NEEDED TO OPERATE THE EMERGENCY CENTER AND PROVIDES ON-SITE EMERGENCY MEDICAL, RESCUE AND MEDICAL TRANSPORTATION SERVICES. IN ADDITION, AVERA SACRED HEART, THROUGH ITS INTEGRATED NETWORK OF PROVIDERS, PROVIDES NON-EMERGENCY SERVICES TO THE COMMUNITY IT SERVES. IT MAKES THESE SERVICES ACCESSIBLE TO THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT PROGRAMS LIKE MEDICARE AND MEDICAID, REGARDLESS OF ABILITY TO PAY. AVERA'S CHARITY CARE POLICY PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE CHARITY CARE POLICY IS DESIGNED TO ENSURE THE COMMUNITIES SERVED BY AVERA FACILITIES HAVE ACCESS TO NEEDED HEALTHCARE SERVICES. THE AVERA SACRED HEART BOARD OF DIRECTORS OVERSEES SERVICES DELIVERED UNDER THE CHARITY CARE POLICY INCLUDING ASSESSING COMMUNITY NEEDS, APPROVING ELIGIBILITY CRITERIA AND MONITORING THE EFFECTIVENESS OF THE PROGRAM IN PROVIDING COMMUNITY ACCESS TO MEDICAL CARE.ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME AND ASSET LEVELS AND FAMILY SIZE. APPLICATIONS FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY AVERA SACRED HEART PATIENT REGISTRATION AREA OR BY CALLING THE AVERA SACRED HEART OR AVERA CREIGHTON BUSINESS OFFICE. SACRED HEART HEALTH SERVICES MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE PROVIDED UNDER THE CHARITY CARE POLICY. SACRED HEART HEALTH SERVICES HAD CHARGES FORGONE FOR CHARITY FOR THE YEAR ENDED JUNE 30, 2014 OF APPROXIMATELY $2,353,000.SACRED HEART HEALTH SERVICES TAKES ITS MISSION TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IT SERVES A STEP FURTHER BY REACHING OUT TO MEET THE BROAD HEALTH NEEDS OF THE COMMUNITY. IT STRIVES TO IDENTIFY COMMUNITY NEEDS BEYOND BASIC HEALTH CARE, RESPOND TO THEM, AIMING TO MAKE A POSITIVE, LIFE-ENHANCING DIFFERENCE IN THE COMMUNITY. SACRED HEART HEALTH SERVICES TAKES A STRATEGIC, COMMUNITY NEEDS-BASED APPROACH TO DELIVERING BENEFITS TO THE COMMUNITY. AVERA SACRED HEART HOSPITAL DEMONSTRATES ITS COMMITMENT TO PROVIDING COMMUNITY BENEFIT THROUGH SPECIFIC ACCOMPLISHMENTS:E-TECHNOLOGY: AVERA SACRED HEART STARTED WITH ITS EICU PROGRAM SIX YEARS AGO. EICU IS A TELEMEDICINE-BASED SYSTEM THAT AIDS IN THE CARE OF ICU PATIENTS AT AVERA SACRED HEART AND ACROSS THE AVERA SYSTEM. PATIENTS RECEIVE CONSTANT, AROUND-THE-CLOCK MONITORING AND INTERVENTIONS FROM A REMOTE CARE TEAM IN ADDITION TO THE CARE THEY RECEIVE FROM THEIR BEDSIDE TEAM. IN ADDITION, AVERA SACRED HEART HOSPITAL, ALONG WITH ST. MICHAEL'S HOSPITAL/AVERA AND WAGNER COMMUNITY MEMORIAL HOSPITAL/AVERA, HAS LAUNCHED AN ESTROKE PROGRAM THAT WILL ENABLE PATIENTS SUFFERING STROKES TO BE MORE QUICKLY DIAGNOSED AND TREATED THROUGH THE USE OF TELEMEDICINE. AVERA HAS ALSO IMPLEMENTED AN E-PHARMACY PROGRAM WHERE FACILITIES WITHOUT 24 HOUR A DAY PHARMACIST COVERAGE CAN ACCESS PHARMACIST SERVICES REMOTELY.TEACHING HOSPITAL: AVERA SACRED HEART IS A TEACHING HOSPITAL, WHICH REFLECTS A STRONG COMMITMENT TO EDUCATION, RESEARCH AND A HIGH LEVEL OF CARE. IN THE SUMMER OF 2007, THE HOSPITAL OPENED THE NEW AVERA PROFESSIONAL OFFICE PAVILION & EDUCATION CENTER TO ENHANCE THEIR COMMITMENT TO MEDICAL EDUCATION. THE AVERA PAVILION IS THE NEW HOME OF THE UNIQUE YANKTON AMBULATORY PROGRAM FOR THE THIRD-YEAR MEDICAL STUDENTS OF THE SANFORD SCHOOL OF MEDICINE OF THE UNIVERSITY OF SOUTH DAKOTA. THE PROGRAM CHALLENGES MEDICAL STUDENTS TO SOLVE CLINICAL PROBLEMS AND EXPERIENCE THE DOCTOR-PATIENT RELATIONSHIP THROUGH THE YEAR. YANKTON IS ONLY ONE OF THREE COMMUNITIES IN THE STATE WHERE A CAMPUS IS PROVIDED FOR THE SANFORD SCHOOL OF MEDICINE. THE OFFICE FOR THE DEAN OF THE YANKTON AMBULATORY PROGRAM OF THE AVERA SACRED HEART YANKTON CAMPUS IS NOW LOCATED ON THE FIRST FLOOR OF THE PAVILION. STUDY SPACE FOR THE MEDICAL STUDENTS IS ADJACENT TO THE ASHH MEDICAL LIBRARY. A UNIQUE COMPONENT TO THE PAVILION IS THE EXPANSION AND ENHANCEMENT OF EDUCATIONAL FACILITIES. ALONG WITH A 116-SEAT AUDITORIUM, THERE ARE ALSO THREE CONFERENCE ROOMS, ALL EQUIPPED WITH THE LATEST IN AUDIOVISUAL TECHNOLOGY.(CONTINUED ON PAGE 8 OF SCHEDULE O)	Desc
Total Program Service Expenses	$86,845,134	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	Yes (1)	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (1)	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	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	Yes (1)	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	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	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	175	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1268	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	8	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	Yes (1)	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	JAMIE A SCHAEFER	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	6056688776	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 SUMMIT	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROB STEPHENSON
CHAIR	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
MICHAEL PIETILA
VICE CHAIR	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
RYAN LOECKER
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
SR JEANNE ANNETTE WEBER
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
SR ROSEMARY WEBER
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
BRAD DYKES
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
JOHN PORTER
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$1,334,108	$34,581
MARTY JANS
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
SR LUCILLE WELBIG
BOARD MEMBER	2.00	5.00	Yes (X)		$0	$0	$0
SR LYNN MARIE WELBIG
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
WAYNE A KINDLE
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
RUSS DEIDRICHSEN
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
DAN SPECHT
BOARD MEMBER	2.00	0.00	Yes (X)		$0	$0	$0
MICHAEL PETERSON MD
BOARD MEMBER & PHYSICIAN	40.00	0.00	Yes (X)		$566,417	$0	$33,174
PAMELA J REZAC
PRESIDENT & CEO	60.00	2.50	Yes (X)	Yes (X)	$0	$471,589	$34,081
JAMIE A SCHAEFER
SEC/TREAS & VP FINANCE	52.00	1.00		Yes (X)	$195,431	$0	$29,593
DOUGLAS EKEREN
VP NETWORK SERVICES	52.00	2.50			$216,878	$0	$30,770	Yes (X)
GREGORY TAYLOR MD
DIAGNOSTIC RADIOLOGY	40.00	0.00			$539,482	$0	$35,614		Yes (X)
STEVE GUTNIK MD FACP
GASTROENTEROLOGY	40.00	0.00			$727,538	$0	$34,611		Yes (X)
MATTHEW G WINKELBAUER MD
FAMILY MEDICINE	40.00	0.00			$505,370	$0	$13,944		Yes (X)
TERENCE PEDERSEN DPM
PODIATRIC SURGERY	40.00	0.00			$334,797	$0	$33,442		Yes (X)
RALPH TULLO MD
PHYSICIAN	40.00	0.00			$463,698	$0	$30,314		Yes (X)
BARBARA LARSON
FORMER KEY EMPLOYEE-VP PATIENT CARE	0.00	52.00			$179,094	$0	$27,105			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,728,705	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,805,697	TotReportableCompRltdOrgAmt
Total Other Compensation	$337,229	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	48	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
YANKTON ANESTHESIOLOGY PC
1000 W 4TH ST SUITE 13	YANKTON	SD	57078	ANESTHESIOLOGISTS	$1,587,914
AEGIS THERAPIES INC
7160 DALLAS PARKWAY	PLANO	TX	75024	REHAB & THERAPY SERVICES	$1,376,499
YANKTON MEDICAL CLINIC PC
PO BOX 706	YANKTON	SD	57078	PHYSICIAN SERVICES	$1,045,019
BOELTER CONTRACT AND DESIGN LLC
N22 W23685 RIDGEVIEW PKWY WEST	WAUKESHA	WI	53188	FOODSERVICE, HOSPITALITY	$650,266
PHYSICIANS LABORATORY LTD
1301 S CLIFF AVE STE 700	SIOUX FALLS	SD	57105	LAB SERVICES	$232,093

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	10	CntrctRcvdGreaterThan100KCnt
Fundraising	$78,584	FundraisingAmt
Government Grants	$166,964	GovernmentGrantsAmt
All Other Contributions	$422,015	AllOtherContributionsAmt
Noncash Contributions	$64,807	NoncashContributionsAmt
Total Contributions	$667,563	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	622110	$105,442,003	$105,442,003
OTHER REVENUE	900099	$1,941,758	$1,941,758
NONMEDICAL OUTREACH	900099	$1,108,326	$1,108,326
EHR REVENUE	900099	$1,032,957	$1,032,957
INCOME FROM AFFILIATES	900099	$14,202	-$2,714	$16,916

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$161,725	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$161,725	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$109,377,521	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,712,532	TotalRevenueColumnAmt
Exclusion	$1,712,532	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$266,767	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,195,567	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$928,800	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$928,800	TotalRevenueColumnAmt
Exclusion	-$928,800	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$6,327,495	SecuritiesAmt
Other	$469	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

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

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$6,327,495	SecuritiesAmt
Other	$469	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,327,964	TotalRevenueColumnAmt
Exclusion	$6,327,964	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$75,020	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$78,584	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$22,816	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$52,204	TotalRevenueColumnAmt
Exclusion	$52,204	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OPERATING INTEREST	Desc
Business	900099	BusinessCd
Total Revenue Column	$85,645	TotalRevenueColumnAmt
Exclusion	$85,645	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$85,645	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$117,294,629	TotalRevenueColumnAmt
Related Or Exempt Func Income	$109,360,605	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$16,916	UnrelatedBusinessRevenueAmt
Exclusion	$7,249,545	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	$175,581	TotalAmt
Program Services	$175,581	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$20,000	TotalAmt
Program Services	$20,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,095,708	TotalAmt
Program Services	$611,997	ProgramServicesAmt
Management And General	$483,711	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$109,006	TotalAmt
Program Services	$109,006	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$42,740,820	TotalAmt
Program Services	$37,878,258	ProgramServicesAmt
Management And General	$4,765,952	ManagementAndGeneralAmt
Fundraising	$96,610	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,244,141	TotalAmt
Program Services	$1,061,726	ProgramServicesAmt
Management And General	$179,577	ManagementAndGeneralAmt
Fundraising	$2,838	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,367,267	TotalAmt
Program Services	$5,615,887	ProgramServicesAmt
Management And General	$731,238	ManagementAndGeneralAmt
Fundraising	$20,142	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,819,569	TotalAmt
Program Services	$2,458,224	ProgramServicesAmt
Management And General	$354,937	ManagementAndGeneralAmt
Fundraising	$6,408	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$70,712	TotalAmt
Management And General	$70,712	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$7,505	TotalAmt
Management And General	$7,505	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$19,195	TotalAmt
Fundraising	$19,195	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$14,957,349	TotalAmt
Program Services	$6,059,036	ProgramServicesAmt
Management And General	$8,895,245	ManagementAndGeneralAmt
Fundraising	$3,068	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$407,327	TotalAmt
Program Services	$90,120	ProgramServicesAmt
Management And General	$316,268	ManagementAndGeneralAmt
Fundraising	$939	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,031,516	TotalAmt
Program Services	$5,171,004	ProgramServicesAmt
Management And General	$856,178	ManagementAndGeneralAmt
Fundraising	$4,334	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$380,011	TotalAmt
Program Services	$132,119	ProgramServicesAmt
Management And General	$247,892	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,101,580	TotalAmt
Program Services	$2,101,566	ProgramServicesAmt
Management And General	$14	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$365,425	TotalAmt
Program Services	$275,445	ProgramServicesAmt
Management And General	$88,979	ManagementAndGeneralAmt
Fundraising	$1,001	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$531,648	TotalAmt
Program Services	$158,898	ProgramServicesAmt
Management And General	$370,922	ManagementAndGeneralAmt
Fundraising	$1,828	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$609,101	TotalAmt
Program Services	$609,101	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,339,508	TotalAmt
Program Services	$7,339,508	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$907,620	TotalAmt
Program Services	$907,620	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$11,260,046	$11,260,046
BAD DEBT EXPENSE	$3,898,107	$3,898,107
EQUIPMENT LEASE AND REN	$520,701	$379,347	$141,354
LICENSES AND PERMITS	$110,687	$96,870	$13,817

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,535,550	TotalAmt
Program Services	$435,668	ProgramServicesAmt
Management And General	$2,096,590	ManagementAndGeneralAmt
Fundraising	$3,292	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$106,625,680	TotalAmt
Program Services	$86,845,134	ProgramServicesAmt
Management And General	$19,620,891	ManagementAndGeneralAmt
Fundraising	$159,655	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,870,900	BOYAmt
EOY	$6,344,415	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$15,048,834	BOYAmt
EOY	$16,104,452	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$35,416	BOYAmt
EOY	$10,416	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$2,258,638	BOYAmt
EOY	$8,000,000	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,019,902	BOYAmt
EOY	$1,976,313	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,382,969	BOYAmt
EOY	$2,173,199	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$156,548,759	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$90,306,285	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$65,146,451	BOYAmt
EOY	$66,242,474	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$6,688,499	BOYAmt
EOY	$7,047,745	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$156,793,713	BOYAmt
EOY	$177,315,904	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,258,681	BOYAmt
EOY	$840,348	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$637,051	BOYAmt
EOY	$632,156	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$515,736	BOYAmt
EOY	$544,056	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$256,656,790	BOYAmt
EOY	$287,231,478	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,769,301	BOYAmt
EOY	$10,556,444	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$490,836	BOYAmt
EOY	$597,330	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$25,217,086	BOYAmt
EOY	$32,243,561	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$18,259	BOYAmt
EOY	$21,309	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,666,831	BOYAmt
EOY	$1,342,805	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$38,162,313	BOYAmt
EOY	$44,761,449	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$204,444,147	BOYAmt
EOY	$226,856,166	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$13,592,414	BOYAmt
EOY	$15,104,257	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$457,916	BOYAmt
EOY	$509,606	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$218,494,477	BOYAmt
EOY	$242,470,029	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$256,656,790	BOYAmt
EOY	$287,231,478	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$10,668,949	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$13,333,770	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$27,167	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	$12,861	OtherActivitiesAmt
Total Lobbying Expenditures	$12,861	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 SACRED HEART HEALTH SERVICES PAID DUES TO HEALTH ORGANIZATIONS THAT HAVE A PORTION OF THE DUES ATTRIBUTED TO LOBBYING ACTIVITIES. THE AMOUNT ATTRIBUTED TO LOBBYING ACTIVITIES WAS $12,861.	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	$839,365	BeginningYearBalanceAmt
Contributions	$51,690	ContributionsAmt
Investment Earnings Or Losses	$133,464	InvestmentEarningsOrLossesAmt
Other Expenditures	$10,830	OtherExpendituresAmt
End Year Balance	$1,013,689	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$793,011	BeginningYearBalanceAmt
Contributions	$6,400	ContributionsAmt
Investment Earnings Or Losses	$58,742	InvestmentEarningsOrLossesAmt
Other Expenditures	$18,788	OtherExpendituresAmt
End Year Balance	$839,365	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$801,064	BeginningYearBalanceAmt
Contributions	$5,310	ContributionsAmt
Investment Earnings Or Losses	-$480	InvestmentEarningsOrLossesAmt
Other Expenditures	$12,883	OtherExpendituresAmt
End Year Balance	$793,011	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$716,457	BeginningYearBalanceAmt
Contributions	$1,120	ContributionsAmt
Investment Earnings Or Losses	$87,570	InvestmentEarningsOrLossesAmt
Other Expenditures	$4,083	OtherExpendituresAmt
End Year Balance	$801,064	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$676,350	BeginningYearBalanceAmt
Contributions	$540	ContributionsAmt
Investment Earnings Or Losses	$41,680	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,113	OtherExpendituresAmt
End Year Balance	$716,457	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.50000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.50000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,538,850	OtherCostOrOtherBasisAmt
Book Value	$3,538,850	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$102,570,248	OtherCostOrOtherBasisAmt
Depreciation	$57,126,771	DepreciationAmt
Book Value	$45,443,477	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$43,554,329	OtherCostOrOtherBasisAmt
Depreciation	$29,517,669	DepreciationAmt
Book Value	$14,036,660	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,885,332	OtherCostOrOtherBasisAmt
Depreciation	$3,661,845	DepreciationAmt
Book Value	$3,223,487	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$66,242,474	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS	$176,307,352	F
INVESTMENT IN AFFILIATED ORGANIZATION	$1,008,552	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$177,315,904	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$846,217
MARKET VALUE OF INTEREST RATE SWAP	$496,588

Field	Value	IRS element (for citing)
Total Liability	$1,342,805	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$125,950,229	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$13,333,770	NetUnrealizedGainsInvstAmt
Other Revenue	-$2,721,161	OtherRevenueAmt
Revenue Not Reported	$10,612,609	RevenueNotReportedAmt
Revenue Subtotal	$115,337,620	RevenueSubtotalAmt
Other Revenues Not Included	$1,957,009	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$1,957,009	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$117,294,629	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$103,749,656	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$1,022,083	OtherExpensesIncludedAmt
Expenses Not Reported	$1,022,083	ExpensesNotReportedAmt
Expenses Subtotal	$102,727,573	ExpensesSubtotalAmt
Other Expenses Not Included	$3,898,107	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,898,107	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$106,625,680	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, LINE 2B:	RESIDENT TRUST FUNDS ARE HELD ON BEHALF OF THE RESIDENTS.
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENT REPRESENTS DONOR-RESTRICTED ENDOWMENT FUNDS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS.
PART X, LINE 2:	THE ORGANIZATION IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). CERTAIN CONSOLIDATED SUBSIDIARIES, INCLUDING VALLEY HEALTH SERVICES, ARE NOT TAX-EXEMPT ENTITIES AND ARE CONSIDERED PARTNERSHIPS OR DISREGARDED ENTITIES FOR TAX PURPOSES. THE ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE ORGANIZATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE ORGANIZATION FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE ORGANIZATION'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2011.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	ACCUMULATED LOSS INTEREST SWAP -22,247. LOSS ON REFINANCING -9,757. BAD DEBT EXPENSE REPORTED IN INCOME FOR FINANCIAL STATEMENT -3,898,107. RELATED ORGANIZATIONS' REVENUE INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS 1,208,950.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTIONS REPORTED IN FUND BALANCE ON FINANCIAL STATEMENTS 323,798. INVESTMENT INCOME REPORTED IN FUND BALANCE ON FINANCIAL STATEMENTS 1,633,211.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RELATED ORGANIZATIONS' EXPENSES INCLUDED IN CONSOLIDATED FINANCIAL STATEMENT 1,022,083.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE REPORTED IN INCOME FOR FINANCIAL STATEMENT 3,898,107.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
Phone Solicitations	Yes (X)	PhoneSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PAUL J STRAWHECKER INC	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4913 DODGE STREET	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	68132	ZIPCode

Field	Value	IRS element (for citing)
Activity	FUNDRAISING CONSULTING	ActivityTxt
Fundraiser Control Of Funds	0	FundraiserControlOfFundsInd
Gross Receipts	$0	GrossReceiptsAmt
Retained By Contractor	$19,195	RetainedByContractorAmt
Net To Organization	-$19,195	NetToOrganizationAmt

Field	Value	IRS element (for citing)
Total Retained By Contractors	$19,195	TotalRetainedByContractorsAmt
Total Net To Organization	-$19,195	TotalNetToOrganizationAmt
Licensed States	SD	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Name Of Event1	SIMPLY D'VINE	NameOfEvent1Amt
Gross Receipts Event1	$119,025	GrossReceiptsEvent1Amt
Charitable Contri Event1	$78,584	CharitableContriEvent1Amt
Gross Revenue Event1	$40,441	GrossRevenueEvent1Amt
Food And Beverage Event1	$689	FoodAndBeverageEvent1Amt
Entertainment Event1	$700	EntertainmentEvent1Amt
Other Direct Expenses Event1	$9,827	OtherDirectExpensesEvent1Amt
Name Of Event2	ROSES JUST BECAUSE	NameOfEvent2Amt
Gross Receipts Event2	$34,579	GrossReceiptsEvent2Amt
Gross Revenue Event2	$34,579	GrossRevenueEvent2Amt
Other Direct Expenses Event2	$11,600	OtherDirectExpensesEvent2Amt
Gross Receipts Total	$153,604	GrossReceiptsTotalAmt
Charitable Contributions Tot	$78,584	CharitableContributionsTotAmt
Gross Revenue Total Events	$75,020	GrossRevenueTotalEventsAmt
Food And Beverage Total Events	$689	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$700	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$21,427	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$22,816	DirectExpenseSummaryEventsAmt
Net Income Summary	$52,204	NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE G, PART I, LINE 2B, COLUMN (V)	FormAndLineReferenceDesc
Explanation	PAYMENTS TO FUNDRAISER FOR CONSULTING SERVICES TO ASSIST IN FUNDRAISING FOR THE NEW HOSPICE UNIT.	ExplanationTxt

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	1386	PersonsServedCnt
Total Community Benefit Expns	$909,643	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$909,643	NetCommunityBenefitExpnsAmt
Total Expense	0.00890	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	4222	PersonsServedCnt
Total Community Benefit Expns	$16,280,916	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,693,662	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,587,254	NetCommunityBenefitExpnsAmt
Total Expense	0.05440	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	1578	PersonsServedCnt
Total Community Benefit Expns	$5,980,414	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,695,405	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,285,009	NetCommunityBenefitExpnsAmt
Total Expense	0.02220	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	7186	PersonsServedCnt
Total Community Benefit Expns	$23,170,973	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,389,067	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,781,906	NetCommunityBenefitExpnsAmt
Total Expense	0.08550	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	1217	PersonsServedCnt
Total Community Benefit Expns	$690,130	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$95,246	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$594,884	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$244,257	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,951	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$226,306	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	2143	PersonsServedCnt
Total Community Benefit Expns	$3,057,205	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,713,519	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,343,686	NetCommunityBenefitExpnsAmt
Total Expense	0.01310	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	108	PersonsServedCnt
Total Community Benefit Expns	$108,252	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$108,252	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$476,950	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$476,950	NetCommunityBenefitExpnsAmt
Total Expense	0.00460	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	3468	PersonsServedCnt
Total Community Benefit Expns	$4,576,794	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,826,716	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,750,078	NetCommunityBenefitExpnsAmt
Total Expense	0.02680	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	10654	PersonsServedCnt
Total Community Benefit Expns	$27,747,767	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,215,783	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,531,984	NetCommunityBenefitExpnsAmt
Total Expense	0.11230	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$60,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$60,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$60,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$60,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,898,107	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$26,393,378	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$27,652,762	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,259,384	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
AVERA SACRED HEART HOSPITAL
1	501 SUMMIT STREET	YANKTON	SD	57078	WWW.AVERA.ORG/SACRED-HEART/	10576	Yes (X)	Yes (X)	Yes (X)	6 PROVIDER BASED RHCS AND 5 PROVIDER BASED CLINICS
AVERA CREIGHTON HOSPITAL
2	1503 MAIN STREET	CREIGHTON	NE	68729	WWW.AVERA.ORG/CREIGHTON/	490001	Yes (X)	Yes (X)	Yes (X)	1 PROVIDER BASED CLINIC	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	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 Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Rpt Available Upon RequestRptAvailableUponRequestInd	Adopt Implementation StrategyAdoptImplementationStrategyInd	Exec Implementation StrategyExecImplementationStrategyInd	Develop Community Wide PlanDevelopCommunityWidePlanInd	Exec Community Wide PlanExecCommunityWidePlanInd	Include Operational PlanIncludeOperationalPlanInd	Adopt BudgetAdoptBudgetInd	Prioritize Health NeedsPrioritizeHealthNeedsInd	Prioritize ServicesPrioritizeServicesInd	Other Needs AddressedOtherNeedsAddressedInd	All Needs AddressedAllNeedsAddressedInd	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareInd	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Explained BasisExplainedBasisInd	Income LevelIncomeLevelInd	Asset LevelAssetLevelInd	Medical IndigencyMedicalIndigencyInd	Insurance StatusInsuranceStatusInd	Uninsured DiscountUninsuredDiscountInd	Medicaid MedicareMedicaidMedicareInd	State RegulationStateRegulationInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	Posted On WebsitePostedOnWebsiteInd	Available On RequestAvailableOnRequestInd	Other PublicityOtherPublicityInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	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 SACRED HEART HOSPITAL
1	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	12	Yes (1)	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/SACRED-HEART	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	0	Yes (1)	Yes (1)	150.000000000000	Yes (1)	400.000000000000	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (1)
AVERA CREIGHTON HOSPITAL
2	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	12	Yes (1)	Yes (1)	Yes (1)	Yes (X)	WWW.AVERA.ORG/CREIGHTON/	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	0	Yes (1)	Yes (1)	150.000000000000	Yes (1)	400.000000000000	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (1)

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
AVERA SACRED HEART HOSPITAL	PART V, SECTION B, LINE 3: AVERA SACRED HEART HOSPITAL UTILIZED A CONSULTANT TO ASSIST WITH THE PROCESS OF CONDUCTING FOCUS GROUPS TO ENSURE PARTICIPANTS FELT AT EASE TO SHARE THEIR OPINIONS. ADDITIONAL FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED BY HOSPITAL PERSONNEL IN COUNTIES OUTSIDE THE IMMEDIATE SERVICE AREA. PERSONAL INVITATIONS WERE SENT TO ORGANIZATIONS AND INDIVIDUALS REPRESENTING THE BROAD INTEREST OF THE COMMUNITIES, INCLUDING AREAS MOST IMPACTED BY HEALTH DISPARITIES.
AVERA CREIGHTON HOSPITAL	PART V, SECTION B, LINE 3: AVERA CREIGHTON HOSPITAL USED INTERVIEWS, SURVEYS, AND FOCUS GROUPS ENSURING THEY REACHED INDIVIDUALS WITH SPECIFIC KNOWLEDGE REGARDING INSURANCE ISSUES, HEALTH REFORM, MEDICAL SPECIALISTS, RURAL HEALTH ISSUES, POPULATION ISOLATION, JOB LOSS, WATER ISSUES, SKIN CANCER, AFFORDABLE HOUSING, AND ELDERLY. SPECIFIC TARGETED PARTICIPANTS INCLUDED REPRESENTATIVES OF NORTH CENTRAL DISTRICT HEALTH DEPARTMENT, NORTH CENTRAL COMMUNITY CARE PARTNERSHIP, REGION 4 BEHAVIORAL HEALTH SYSTEM, AND HEARTLAND COUNSELING.
AVERA CREIGHTON HOSPITAL	PART V, SECTION B, LINE 4: AVERA CREIGHTON HOSPITAL PARTNERED WITH THE TEN OTHER HOSPITALS IN THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT INCLUDING ANTELOPE MEMORIAL HOSPITAL, AVERA ST. ANTHONY'S HOSPITAL, OSMOND GENERAL HOSPITAL, PLAINVIEW COMMUNITY HOSPITAL, TILDEN COMMUNITY HOSPITAL, NIOBRARA VALLEY HOSPITAL, WEST HOLT MEMORIAL HOSPITAL, BROWN COUNTY HOSPITAL, CHERRY COUNTY HOSPITAL, AND ROCK COUNTY HOSPITAL IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT.
AVERA SACRED HEART HOSPITAL	PART V, SECTION B, LINE 6I: THE IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTP://WWW.AVERA.ORG/EXPERIENCE/SHARED/COMMUNITY-NEEDS-HEALTH-ASSESSMENTS/.
AVERA CREIGHTON HOSPITAL	PART V, SECTION B, LINE 6I: THE IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTP://WWW.AVERA.ORG/EXPERIENCE/SHARED/COMMUNITY-NEEDS-HEALTH-ASSESSMENTS/.
AVERA SACRED HEART HOSPITAL	PART V, SECTION B, LINE 14G: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED ON THE BILLING INVOICES, IN THE EMERGENCY ROOM, WAITING ROOMS, IN THE ADMISSIONS OFFICE, AND TO PATIENTS UPON ADMISSION.
AVERA CREIGHTON HOSPITAL	PART V, SECTION B, LINE 14G: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED ON THE BILLING INVOICES, IN THE EMERGENCY ROOM, WAITING ROOMS, IN THE ADMISSIONS OFFICE, AND TO PATIENTS UPON ADMISSION.
AVERA SACRED HEART HOSPITAL	PART V, SECTION B, LINE 22: 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 CREIGHTON HOSPITAL	PART V, SECTION B, LINE 22: 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.

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
AVERA YANKTON CARE CENTER
1212 W 8TH STREET	YANKTON	SD	57078	SKILLED NURSING FACILITY
AVERA SISTER JAMES CARE CENTER
2111 W 11TH STREET	YANKTON	SD	57078	SKILLED NURSING FACILITY
AVERA SACRED HEART MAJESTIC BLUFFS
2111 W 11TH STREET	YANKTON	SD	57078	ASSISTED LIVING
AVERA SACRED HEART HOSPITAL-SWING BED
501 SUMMIT STREET	YANKTON	SD	57078	SWING BED
AVERA CREIGHTON CARE CENTRE
1603 MAIN STREET	CREIGHTON	NE	687292999	LONG TERM CARE
AVERA SACRED HEART HOSPITAL-DIALYSIS
501 SUMMIT STREET	YANKTON	SD	57078	DIALYSIS UNIT

Supplemental Information Detail SupplementalInformationDetail (15 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, UNREIMBURSED MEDICAID, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS WERE CONVERTED TO COST USING THE COST-TO-CHARGE RATIO BASED ON THE MEDICARE COST REPORT FROM THE PRIOR YEAR. UNREIMBURSED MEDICAID USES A COST-TO-CHARGE RATIO THAT INCLUDES OTHER ACTIVITIES BEYOND HOSPITAL INPATIENT. THE AMOUNTS ON LINES 7E-I REPRESENT EXPENSES REPORTED IN THE GENERAL LEDGER AND COMPILED USING CBISA SOFTWARE.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $3,898,107 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE PARTICIPATION IN THE YANKTON AREA PROGRESSIVE GROWTH YES CAMPAIGN STRENGTHENS THE COMMUNITY'S CAPACITY TO PROMOTE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE RESOURCES AND EXPERTISE OF THE HOSPITAL.
PART III, LINE 2:	BAD DEBT EXPENSE IS REPORTED NET OF DISCOUNTS AND CONTRACTUAL ALLOWANCES. A PAYMENT ON AN ACCOUNT PREVIOUSLY WRITTEN OFF REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR. BAD DEBT IS REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION.
PART III, LINE 3:	SACRED HEART HEALTH SERVICES DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE SINCE EVALUATIONS ARE COMPLETED TO DETERMINE THOSE AMOUNTS DUE AND WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE EVALUATION OF THE AMOUNT.
PART III, LINE 4:	NOTE 1 ON PAGE 8 OF THE FINANCIAL STATEMENTS DESCRIBES BAD DEBT EXPENSE.
PART III, LINE 8:	PART III, LINES 5, 6, AND 7: THE MEDICARE REVENUES RECEIVED (LINE 5), ALLOWABLE COSTS (LINE 6), AND THE RESULTING SHORTFALL (LINE 7) DOES NOT INCLUDE A SIGNIFICANT PORTION OF THE ORGANIZATION'S EXPENSES. THESE LINES REQUIRE USE OF THE MEDICARE COST REPORT AS PREPARED BY THE REQUIRED GUIDELINES WHICH DISALLOWS NUMEROUS COSTS OF HOSPITALS, PARTICULARLY IF THEY ARE PART OF AN INTEGRATED SYSTEM SUCH AS SACRED HEART HEALTH SERVICES. IN THESE CASES THE ENTITY MUST FILE A HOME OFFICE COST REPORT WHICH "STEPS DOWN" OVERHEAD TO NON-COST REPORT ENTITIES DISPROPORTIONATELY TO ACTUAL ALLOWABLE SHARE AND ESSENTIALLY REMOVING THE COSTS FROM THE HOSPITAL'S COST REPORT ENTIRELY. EXAMPLES OF NON-COST REPORT ENTITIES OPERATED BY SACRED HEART HEALTH SERVICES INCLUDE CLINICS, A HOME MEDICAL EQUIPMENT STORE, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES. THERE ARE ALSO COSTS COMPLETELY DISALLOWED BY COST REPORT RULES SUCH AS BAD DEBT EXPENSE, MARKETING, CRNA'S, AND INTEREST EXPENSE. IN ADDITION TO THESE DISALLOWED COSTS WITHIN THE HOSPITAL, SACRED HEART HEALTH SERVICES OPERATES CLINICS, A HOME MEDICAL EQUIPMENT STORE, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES WHICH DO NOT FILE A COST REPORT.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. SACRED HEART HEALTH SERVICES FOLLOWS THE CHA GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL IS EXCLUDED FROM OUR COMMUNITY BENEFIT REPORT. HOWEVER, MEDICARE IS THE ORGANIZATION'S LARGEST PAYER AND PATIENTS WITH MEDICARE COVERAGE ARE ACCEPTED REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED FROM PROVIDING THE SERVICES. THIS BASIS THEREFORE MEANS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A KEY ADVANTAGE FOR OUR COMMUNITY.
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 COLLECTION AGENCY. 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. SACRED HEART HEALTH SERVICES DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES SACRED HEART HEALTH SERVICES UTILIZES MAY REPORT TO THE CREDIT AGENCIES. ANY EXTENDED PAYMENT PLANS OFFERED BY THE HOSPITAL, OR THE HOSPITAL'S REPRESENTATIVE, IN SETTLING THE OUTSTANDING BILLS OF PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
PART VI, LINE 2:	AVERA SACRED HEART HOSPITAL INCLUDES COMMUNITY MEMBERS ON COMMITTEES, BOARDS AND ADVISORY GROUPS TO ALLOW COMMUNITY REACTION AND INPUT IN THE ACTIONS WE TAKE. WE ALSO REVIEW ALL DATA PROVIDED BY THE HEALTH DEPARTMENTS REGARDING DISEASE RATES, MORTALITY, MORBIDITY, POPULATION CHANGES, ETC. THE HOSPITAL ALSO CONDUCTS FOCUS GROUPS, CONSUMER PERCEPTION STUDIES, AND PATIENT SATISFACTION SURVEYS TO IDENTIFY PRIMARY NEEDS OF THE COMMUNITY AND RESPONDS WITH PREVENTATIVE/EDUCATIONAL INFORMATION OR ACTIVITIES FOR THE COMMUNITY.
PART VI, LINE 3:	THE BROCHURE "UNDERSTANDING YOUR HEALTH CARE BILLS" IS PROVIDED IN VISIBLE LOCATIONS EXPERIENCING HIGH VOLUMES OF INPATIENT OR OUTPATIENT REGISTRATIONS SUCH AS THE ADMITTING OFFICE, THE BILLING/BUSINESS OFFICE, AND EMERGENCY DEPARTMENT AS WELL AS THE ORGANIZATION WEBSITE. PATIENTS ARE ALSO MADE AWARE OF POSSIBLE ELIGIBILITY WHEN GIVEN THE "PATIENT RIGHTS AND RESPONSIBILITIES" BROCHURE UPON ADMISSION. THE PATIENT ADVOCATE WORKS WITH UNINSURED/UNDERINSURED PATIENTS TO ENROLL THEM IN APPLICABLE SOCIAL SERVICE PROGRAMS AND/OR IDENTIFY CHARITY, COUNTY OR RISK POOL ELIGIBILITY.
PART VI, LINE 4:	AVERA SACRED HEART HOSPITAL PRIMARILY SERVES THE CITY AND COUNTY OF YANKTON, SD AND THE SURROUNDING SOUTH DAKOTA COUNTIES OF BON HOMME, CHARLES MIX, CLAY AND HUTCHINSON, AND CEDAR COUNTY AND KNOX IN NEBRASKA. U.S CENSUS STATISTICS INDICATE THAT 15.4% OF THE CITY OF YANKTON'S INDIVIDUAL RESIDENTS FALL BELOW THE FEDERAL POVERTY GUIDELINES. FOR FISCAL YEAR 2014, 46.5% OF OUR REVENUE CAME FROM MEDICARE AND MEDICARE ADVANTAGE PLANS, AND 12.3% CAME FROM MEDICAID AND MEDICAID REPLACEMENT PLANS.
PART VI, LINE 5:	THE HOSPITAL BOARD IS COMPRISED OF INDIVIDUALS WHO REPRESENT THE INTERESTS OF THE COMMUNITY SERVED BY THE ORGANIZATION. THE HOSPITAL OFFERS STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SELECTED SERVICES SUCH AS RADIATION ONCOLOGY AND SWINGBED SERVICES WOULD NOT BE AVAILABLE IN OUR SERVICE AREA UNLESS PROVIDED BY THE ORGANIZATION. THE HOSPITAL SERVES ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING 24 HOUR A DAY EMERGENCY SERVICES. THE FACILITY PARTICIPATES IN THE EDUCATION OF MEDICAL STUDENTS FROM THE UNIVERSITY OF SOUTH DAKOTA THROUGH THEIR YANKTON LOCATION. THE HOSPITAL ALSO OFFERS A 2 -YEAR RADIATION TECHNOLOGIST PROGRAM THAT GRADUATES APPROXIMATELY 6 STUDENTS PER YEAR. SACRED HEART HOSPITAL ALSO PROVIDES CLINICAL EDUCATION FOR MOUNT MARTY COLLEGE STUDENTS. THE HOSPITAL IS ALSO PROUD OF THE FACT THAT 355 INDIVIDUALS CHOSE TO VOLUNTEER AT THE FACILITY DURING FISCAL YEAR 2014.
PART VI, LINE 6:	AVERA IS A SPONSORED MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS. THE COMMUNITIES IN WHICH AVERA HEALTH OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFITS NEEDS. IN KEEPING WITH CATHOLIC HEALTH ASSOCIATION GUIDELINES, EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE CORPORATE STAFF OF AVERA HEALTH ADVOCATES FOR ALL MEMBERS REGARDING COMMUNITY BENEFIT RELATED MATTERS OF STATE, REGIONAL AND NATIONAL IMPORTANCE.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
YANKTON YES CAMPAIGN YAPG
803 EAST 4TH STREET	YANKTON	SD	57078	460348636	501(C)(3)	$60,000	ECONOMIC DEVELOPMENT
AVERA ST ANTHONY HOSPITAL
300 N 2ND ST	ONEILL	NE	68763	470463911	501(C)(3)	$20,000	BUILDING PROJECT
UNIVERSITY OF SOUTH DAKOTA
PO BOX 5555	VERMILLION	SD	57069	466000364	STATE OF SD	$50,000	OUTCOMES RESEARCH
UNITED WAY OF YANKTON
610 W 23RD	YANKTON	SD	57078	460252854	501(C)(3)	$12,000	COMMUNITY SUPPORT
REGIONAL TECHNICAL EDUCATION CTR
1200 WEST 21ST STREET	YANKTON	SD	57078	342014700	501(C)(3)	$10,001	PROGRAM SUPPORT
AVERA ST MICHAEL'S HOSPITAL
410 WEST 16TH AVENUE	TYNDALL	SD	57066	460225414	501(C)(3)	$10,000	BUILDING PROJECT

Field	Value	IRS element (for citing)
Total501c3 Org	6	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	EDUCATIONAL SCHOLARSHIPS	GrantTypeTxt
Recipient	4	RecipientCnt
Cash Grant	$20,000	CashGrantAmt

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 ALSO TAX-EXEMPT. INDIVIDUAL SCHOLARSHIP RECIPIENTS ARE SELECTED BY THE UNIVERSITY SCHOOL OF MEDICINE ACCORDING TO ITS CRITERIA. IN FISCAL YEAR 2014, 4 MEDICAL SCHOOL STUDENTS WERE CHOSEN FOR $5,000 SCHOLARSHIPS.	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 (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN PORTER
BOARD MEMBER	$0	$1,038,280	$0	$0	$0	$295,828	$0	$13,475	$0	$23,654	$0	$1,371,237	$0	$0
MICHAEL PETERSON MD
BOARD MEMBER & PHYSICIAN	$563,792	$0	$0	$0	$2,625	$0	$12,512	$0	$20,662	$0	$599,591	$0	$0	$0
PAMELA J REZAC
PRESIDENT & CEO	$0	$378,174	$0	$0	$0	$93,415	$0	$13,475	$0	$21,434	$0	$506,498	$0	$0
JAMIE A SCHAEFER
SEC/TREAS & VP FINANCE	$195,082	$0	$0	$0	$349	$0	$9,931	$0	$19,662	$0	$225,024	$0	$0	$0
DOUGLAS EKEREN
VP NETWORK SERVICES	$215,879	$0	$0	$0	$999	$0	$11,108	$0	$19,662	$0	$247,648	$0	$0	$0
GREGORY TAYLOR MD
DIAGNOSTIC RADIOLOGY	$535,091	$0	$0	$0	$4,391	$0	$12,876	$0	$22,738	$0	$575,096	$0	$0	$0
STEVE GUTNIK MD FACP
GASTROENTEROLOGY	$718,019	$0	$0	$0	$9,519	$0	$12,449	$0	$22,162	$0	$762,149	$0	$0	$0
MATTHEW G WINKELBAUER MD
FAMILY MEDICINE	$504,397	$0	$0	$0	$973	$0	$12,738	$0	$1,206	$0	$519,314	$0	$0	$0
TERENCE PEDERSEN DPM
PODIATRIC SURGERY	$312,133	$0	$21,765	$0	$899	$0	$12,780	$0	$20,662	$0	$368,239	$0	$0	$0
RALPH TULLO MD
PHYSICIAN	$459,307	$0	$0	$0	$4,391	$0	$12,938	$0	$17,377	$0	$494,013	$0	$0	$0
BARBARA LARSON
FORMER KEY EMPLOYEE-VP PATIENT CARE	$171,992	$0	$0	$0	$7,102	$0	$8,499	$0	$18,606	$0	$206,199	$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 SACRED HEART 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

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Field	Value	IRS element (for citing)
Person	GREGORY TAYLOR	PersonNm
Relationship With Org	EMPLOYEE	RelationshipWithOrgTxt
Loan Purpose	PHYSICIAN COMMUNITY NEEDS	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$100,000	OriginalPrincipalAmt
Balance Due	$10,416	BalanceDueAmt
Default	0	DefaultInd
Board Or Committee Approval	0	BoardOrCommitteeApprovalInd
Written Agreement	Yes (1)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$10,416	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
JANET JANS
SPOUSE OF BOARD MEMBER	$62,547	EMPLOYEE COMPENSATION	0
ALLISON DIEDRICHSEN
SPOUSE OF BOARD MEMBER	$29,492	EMPLOYEE COMPENSATION	0
YANKTON MEDICAL CLINIC
PARTNER OF YANKTON MEDICAL CLINIC IS BOARD MEMBER OF ORGANIZATION	$1,308,796	PROFESSIONAL SERVICES	0
MARY LOECKER
PARENT OF BOARD MEMBER	$16,967	EMPLOYEE COMPENSATION	0

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Noncash Contributions Rpt F990	$51,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Food Inventory FoodInventoryGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	33	ContributionCnt
Noncash Contributions Rpt F990	$13,807	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	JOHN PORTER, SR. LUCILLE WELBIG AND PAMELA J. REZAC HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE ORGANIZATION IS AVERA HEALTH, A NONPROFIT CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF SOUTH DAKOTA AND EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.
FORM 990, PART VI, SECTION A, LINE 7A	AVERA HEALTH, AS THE SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	AVERA HEALTH 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 B, LINE 11	THE FORM 990 IS REVIEWED INITIALLY BY THE CEO AND 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 BOARD MEMBERS. 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 SYSTEM. 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 OTHER OFFICERS, DIRECTORS, AND KEY EMPLOYEES IS REVIEWED ANNUALLY. THE ORGANIZATION UTILIZES THE RESOURCES OF AN OUTSIDE INDEPENDENT AGENCY FOR MARKET COMPARABILITY. THE COMPENSATION IS APPROVED WITHIN THE ANNUAL BUDGET APPROVED BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11G	REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 1,658,558. MANAGEMENT AND GENERAL EXPENSES 314,649. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,973,207. CONSULTING: PROGRAM SERVICE EXPENSES 776,696. MANAGEMENT AND GENERAL EXPENSES 44,467. FUNDRAISING EXPENSES 3,068. TOTAL EXPENSES 824,231. PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,623,782. MANAGEMENT AND GENERAL EXPENSES 3,234,768. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,858,550. ACS FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,301,361. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,301,361.
FORM 990, PART XI, LINE 9:	CAPITAL TRANSFERS, NET 295,082. NET ASSETS RELEASED FROM DONOR RESTRICTION -312,493. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -9,756.
FORM 990, PART XII, LINE 2C:	THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR SACRED HEART HEALTH SERVICES.
PART III, LINE 4A:	(CONTINUED FROM PAGE 4 OF SCHEDULE O) RESIDENCY/HEALTH PROFESSIONS TRAINING: AT ANY ONE TIME, 10 TO 15 SANFORD SCHOOL OF MEDICINE OF THE UNIVERSITY OF SOUTH DAKOTA MEDICAL STUDENTS ARE IN TRAINING AT AVERA SACRED HEART HOSPITAL. IN ADDITION, STUDENTS IN NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, RADIOLOGY AND RESPIRATORY THERAPY ALSO AFFILIATE HERE. AVERA SACRED HEART ALSO HAS A RADIOLOGY TECHNOLOGIST SCHOOL, WHICH GRADUATES 6 TO 8 NEW RADIOLOGY TECHNOLOGISTS EACH YEAR. PREVENTIVE CARE A PRIORITY: AVERA SACRED HEART HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES THROUGH THE MANY EDUCATIONAL PROGRAMS, HEALTH SCREENINGS AND FAIRS THAT ARE HELD THROUGHOUT THE YEAR. AVERA SACRED HEART HOLDS SCREENINGS THROUGHOUT THE REGION AT THEIR RURAL HEALTH CLINICS AS WELL AS IN YANKTON. THE HOSPITAL IS NOW CONNECTED TO THE ASK-A-NURSE PROGRAM THAT PROVIDES GENERAL INFORMATION CONCERNING HEALTH-RELATED TOPICS. OUR WEB SITE INCORPORATES THE "ADAM" SOFTWARE THAT PROVIDES A UNIQUE LEVEL OF HEALTH-RELATED INFORMATION TO THE CONSUMER. IN 2009, AVERA SACRED HEART HOSPITAL INTRODUCED PLANET HEART (IN CONJUNCTION WITH THE AVERA HEART HOSPITAL) AND AN IN-HOUSE CARDIOVASCULAR SCREENING PACKAGE TO KEEP THE PEOPLE WE SERVED BETTER INFORMED ABOUT THEIR HEALTH. BASED ON COMMUNITY NEEDS, WE ARE CONTINUALLY STRIVING TO PROVIDE MORE PREVENTATIVE TOOLS AND RISK ASSESSMENTS TO OUR POPULATION. COMMUNITY EDUCATION: AVERA SACRED HEART REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT SOUTHEASTERN SOUTH DAKOTA AND NORTHEASTERN NEBRASKA IN A VARIETY OF WAYS. FOR THE PAST FIVE YEARS, AVERA SACRED HEART HAS PARTNERED WITH HYVEE FOODS OF YANKTON AND THE YANKTON PUBLIC SCHOOL SYSTEM TO PROMOTE BETTER EATING HABITS FOR STUDENTS AND CENTERED ON THE "MY PLATE" CONCEPT. COMMUNITY FLU SHOT CLINICS ARE GENERALLY HELD THROUGHOUT THE REGION. THROUGH WELL COORDINATED EFFORTS STATEWIDE WITH OTHER HOSPITALS AND STATE ENTITIES, AVERA SACRED HEART WAS ABLE TO EFFECTIVELY DISTRIBUTE THE VACCINE DOSES IT RECEIVED IN A TIMELY AND EFFICIENT MANNER. WE ARE PROUD OF OUR CONTINUING 'TO BE WELL' HEALTH CARE EDUCATIONAL SERIES THAT PROVIDES EDUCATION TO THE COMMUNITY ON A VARIETY OF DISEASES AND CHRONIC CONDITIONS. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, STUDENTS, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS OF ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING THE AVERA PROFESSIONAL OFFICE PAVILION AND EDUCATION CENTER, HUNDREDS OF CLASSES INVOLVING THOUSANDS OF PEOPLE ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR. OTHER EXAMPLES OF COMMUNITY EDUCATION INCLUDE OUR STUDENT/YOUTH MENTORING PROGRAMS AND PARISH NURSING. PARTNERSHIPS WITH SCHOOLS, CHURCHES, BUSINESSES AND OTHER ORGANIZATIONS MAKE MANY OF THESE PROGRAMS POSSIBLE. AS AN INTEGRATED ORGANIZATION, AVERA AND AVERA SACRED HEART ARE LEADERS IN THE IMPLEMENTATION OF THE ELECTRONIC PATIENT RECORD (EMR). IN FISCAL YEAR 2013, SEVERAL NEW CLINICS WERE ADDED TO THE ASHH ELECTRONIC MEDICAL RECORD SYSTEM AS THE NATION MOVES TOWARD MORE INTEGRATED MEDICINE. COMMITMENT TO QUALITY: AVERA SACRED HEART IS ACCREDITED BY THE JOINT COMMISSION AND JUST RECEIVED ANOTHER THREE-YEAR ACCREDITATION IN 2011.
FORM 990, PART VI, LINE 16:	THERE IS NO WRITTEN POLICY OR PROCEDURE. IN THE EVENT OF ANY SUCH PROPOSED TRANSACTION, THE BOARD OR A COMMITTEE WITH DELEGATED AUTHORITY REVIEWS ALL MATERIALS, VALUATIONS AND OPERATIONAL ASPECTS FOR ANY PROPOSED TRANSACTION. SUCH TRANSACTION WOULD BE EVALUATED IN ACCORDANCE WITH THE EXEMPT STATUS OF THE ORGANIZATION AND ITS APPLICABLE PURPOSES. ANY TRANSACTION ALSO WOULD BE APPROVED BY THE BOARD AND THE MEMBER.
FORM 990, PART X, LINE 20:	THE ISSUE PRICE INCLUDES THE FILING ORGANIZATION'S SHARE OF THE ENTIRE BOND ISSUE, WHICH WAS ISSUED TO AVERA HEALTH ON BEHALF OF THE AVERA OBLIGATED GROUP. THE AVERA OBLIGATED GROUP CONSISTS OF AVERA HEALTH, AVERA MCKENNAN, AVERA ST. LUKE'S, AVERA QUEEN OF PEACE, AVERA MARSHALL, AVERA ST. MARY'S, AND SACRED HEART HEALTH SERVICES. IN ACCORDANCE WITH IRS INSTRUCTIONS, INFORMATION RELATED TO THE TAX EXEMPT BOND REPORTING IS BEING REPORTED ON AVERA HEALTH'S TAX RETURN (EIN 46-0422673).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1
AVERA HEALTH
3900 WEST AVERA DRIVE SUITE 300	SIOUX FALLS	SD	57108	460422673	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 9	N/A	0
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		Yes (1)	SACRED HEART HEALTH SERVICES
AVERA ST ANTHONY'S HOSPITAL
300 N 2ND STREET	ONEILL	NE	68763	470463911	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA HOLY FAMILY
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	420680370	HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	421317452	FUNDRAISING	IA	501(C)(3)	LINE 9		0	AVERA HOLY FAMILY
AVERA MARSHALL
300 S BRUCE ST	MARSHALL	MN	56258	410919153	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA MARSHALL FOUNDATION
300 S BRUCE ST	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
AVERA QUEEN OF PEACE HOSPITAL
525 N FOSTER STREET	MITCHELL	SD	57301	460224604	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA ST LUKE'S
305 SOUTH STATE STREET	ABERDEEN	SD	57401	460224598	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH
AVERA GETTYSBURG
606 EAST GARFIELD	GETTYSBURG	SD	57442	460234354	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA ST MARY'S
AVERA ST MARY'S
801 EAST SIOUX AVENUE	PIERRE	SD	57501	460230199	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3		0	AVERA HEALTH

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA ST	ABERDEEN	SD	57401	460461429	SURGICAL ASSOCIATES	SD	N/A
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	57117	460488198	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD		AVERA MCKENNAN	RELATED	$60,447	$933,931	0	0	0.23000
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 MN AVE 102	SIOUX FALLS	SD	57117	800619999	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
Q&M PROPERTIES
525 NORTH FOSTER	MITCHELL	SD	57301	731652049	MEDICAL CLINIC BUILDING	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 (4 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
VALLEY HEALTH SERVICES INC
501 SUMMIT STREET	YANKTON	SD	57078	460357149	RENTAL REAL ESTATE	SD	SACRED HEART HEALTH SERVICES	C	$66,121	$1,539,094	1.00000	0
ACCOUNTS MANAGEMENT INC
5132 S CLIFF AVE SUITE 101	SIOUX FALLS	SD	57108	460373021	COLLECTION AGENCY	SD		C				0	N/A
AVERA HEALTH PLANS INC
3900 WEST AVERA DRIVE SUITE 101	SIOUX FALLS	SD	57108	460451539	HEALTH FINANCING AND HEALTH PLAN ADMINISTRATION	SD		C				0	N/A
AVERA PROPERTY INSURANCE INC
610 W 23RD ST STE 1 PO BOX 38	YANKTON	SD	57078	460463155	INSURANCE	SD		C				0	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	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	Yes (1)	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	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
L	$101,820	RECORDED IN GENERAL LEDGER
AVERA MCKENNAN
L	$55,380	RECORDED IN GENERAL LEDGER
AVERA MCKENNAN
M	$957,426	RECORDED IN GENERAL LEDGER