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AVERA QUEEN OF PEACE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
AVERA QUEEN OF PEACE (EIN 46-0224604)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201241369349305064
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T13:23:43-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 NICOLLET MALL STE 1300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN460224604EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AVERA QUEEN OF PEACE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAVERNameControl
Phone6059952251Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1525 NORTH FOSTER STREETAddressLine1
CityMITCHELLCity
StateSDState
ZIP Code57301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM E FLETTName
TitleSEC/TREAS & VP OF FINANCETitle
Phone6059952251Phone
Date Signed2012-05-14DateSigned
Authorize Third Party0AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM HUNWARDSEN CPAName
Phone6122536500Phone
Date Prepared2012-05-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1AVERA QUEEN OF PEACE HEALTH SERVICEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS A CLARKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1525 NORTH FOSTER STREETAddressLine1
CityMITCHELLCity
StateSDState
ZIP Code57301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts86034601GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.AVERAQUEENOFPEACE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1905YearFormation
State Legal DomicileSDStateLegalDomicile
Activity Or Mission DescriptionPROMOTION OF HEALTHActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees876TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1511770ContributionsGrantsPriorYear
Contributions Grants Current Year1259988ContributionsGrantsCurrentYear
Program Service Revenue Prior Year78383045ProgramServiceRevenuePriorYear
Program Service Revenue CY82985131ProgramServiceRevenueCY
Investment Income Prior Year500668InvestmentIncomePriorYear
Investment Income Current Year1329553InvestmentIncomeCurrentYear
Other Revenue Prior Year-899OtherRevenuePriorYear
Other Revenue Current Year-82807OtherRevenueCurrentYear
Total Revenue Prior Year80394584TotalRevenuePriorYear
Total Revenue Current Year85491865TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year118268GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY163174GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year46365915SalariesEtcPriorYear
Salaries Etc Current Year47230003SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year48942TotalFundrsngExpCurrentYear
Other Expense Prior Year30201254OtherExpensePriorYear
Other Expenses Current Year32188106OtherExpensesCurrentYear
Total Expenses Prior Year76685437TotalExpensesPriorYear
Total Expenses Current Year79581283TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3709147RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5910582RevenuesLessExpensesCY
Total Assets BOY95601707TotalAssetsBOY
Total Assets EOY105824301TotalAssetsEOY
Total Liabilities BOY32298853TotalLiabilitiesBOY
Total Liabilities EOY32789972TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY63302854NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY73034329NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAVERA 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense64112115Expense
Grants163174Grants
Revenue82985131Revenue
DescriptionAVERA QUEEN OF PEACE'S MISSION IS TO PROVIDE HEALTHCARE SERVICES TO MITCHELL, SD RESIDENTS AND SURROUNDING AREA. THEY PROVIDE ACUTE CARE AND LONG-TERM HEALTHCARE SERVICES, OF WHICH THERE WERE 8,985 ACUTE PATIENT DAYS, 2,626 SWING-BED PATIENT DAYS, 1,151 NURSERY PATIENT DAYS, AND 41,822 NURSING HOME RESIDENT DAYS. THE BREAKOUT OF THESE STATISTICS PER FACILITY IS AS FOLLOWS.AVERA QUEEN OF PEACE HOSPITAL8,420 ACUTE PATIENT DAYS1,940 SWING-BED PATIENT DAYS1,151 NEWBORN PATIENT DAYSAVERA BRADY HEALTH AND REHABILITATION29,804 LONG-TERM CARE RESIDENT DAYS9,300 ASSISTED LIVING DAYS2,718 INDEPENDENT LIVING DAYSAVERA WESKOTA MEMORIAL MEDICAL CENTER (CAH)394 ACUTE PATIENT DAYS461 SWING-BED PATIENT DAYSAVERA DE SMET MEMORIAL HOSPITAL (CAH)171 ACUTE PATIENT DAYS225 SWING-BED PATIENT DAYS AVERA QUEEN OF PEACE MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND EQUIVALENT SERVICE STATISTICS. THE AMOUNT OF CHARGES FOREGONE, BASED ON ESTABLISHED RATES, WERE $1,928,334.AVERA QUEEN OF PEACE ALSO PROVIDES COMMUNITY BENEFIT HEALTH ACTIVITIES AT LESS THAN OR AT NO COST TO SUPPORT THOSE IN THE AREA SERVICED. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION PROGRAMS; SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND MEDICALLY UNDERSERVED; AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING THE YEAR ENDED JUNE 30, 2011, SPECIFIC ACTIVITIES INCLUDE MEALS DELIVERED TO RESIDENTIAL HOMES; MEETING FACILITIES; PROGRAMS FOR PATIENTS AND FAMILIES SUFFERING FROM CANCER, DIABETES, BREATHING DISORDERS, AND OTHERS; ASSISTANCE TO HEALTH EDUCATORS; EMERGENCY HEALTHCARE PROVIDERS; WELLNESS PROGRAMS; AND OVERNIGHT HOUSING FOR FAMILIES OF HOSPITALIZED PATIENTS.AS A MEMBER OF THE AVERA HEALTH NETWORK, AVERA QUEEN OF PEACE UPHOLDS THE VISION OF THE PRESENTATION AND BENEDICTINE SISTERS TO WORK THROUGH COLLABORATION TO PROVIDE A QUALITY, EFFECTIVE HEALTH MINISTRY AND TO IMPROVE THE HEALTH CARE OF INDIVIDUALS AND OUR COMMUNITIES THROUGH A REGIONALLY INTEGRATED NETWORK OF PERSONS AND INSTITUTIONS. AVERA QUEEN OF PEACE ENGAGES IN ACTIVITIES DESIGNED TO IMPROVE THE HEALTH OF INDIVIDUALS AND COMMUNITIES IN RESPONSE TO A CALLING TO HEAL THE SICK, THE ELDERLY, AND THE OPPRESSED.Description
Total Program Service Expense64112115TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096141NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees876NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WILL FLETTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6059952251TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1525 NORTH FOSTERAddressLine1
CityMITCHELLCity
StateSDState
ZIP Code57301ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ROGER MUSICK
CHAIRPERSON2.50XX000
LORI ESSIG
VICE CHAIR2.50XX000
LOREN NOESS
BOARD MEMBER2.50X000
CHARLES BERGELEEN
BOARD MEMBER2.50X000
SISTER KATHLEEN CROWLEY
BOARD MEMBER2.50X000
MARK REYNEN DO
BOARD MEMBER (THRU 1-11)2.50X000
SISTER BONITA GACNIK
BOARD MEMBER2.50X000
DAVID OLSON
BOARD MEMBER2.50X000
JACQUELYN JOHNSON
BOARD MEMBER2.50X000
ELMER BIETZ
BOARD MEMBER2.50X000
SISTER LYNN MARIE WELBIG
BOARD MEMBER2.50X000
ROBERT SNORTUM MD
BOARD MEMBER (1-11 - 6-11)2.50X339217034357
JERRY THOMSEN
BOARD MEMBER2.50X000
RODNEY COMBS
BOARD MEMBER2.50X000
TERRY TORGERSON
BOARD MEMBER2.50X000
MICHAEL KRAUSE DO
BOARD MEMBER2.50X4000000
PATRICIA MALTERS MD
BOARD MEMBER2.50X000
GREG VAN WALD
BOARD MEMBER2.50X000
TOM RASMUSSON
PRESIDENT & CEO40.00XX046319030824
PATRICK J CLARK
SEC/TREAS & SRVP OF FINANCE40.00X225074018975
JEROME HOWE MD
PHYSICIAN40.00615152026826X
CHRISTOPHER KROUSE MD
PHYSICIAN40.001105344027683X
MICHAEL HALEY MD
PHYSICIAN40.00689338032688X
DENNIS LELAND MD
PHYSICIAN40.00728767028682X
BRIAN KAMPMANN MD
PHYSICIAN40.00631724028682X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4374616TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs463190TotalReportableCompFrmRltdOrgs
Total Other Compensation228717TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AVERA HEALTH
3900 W AVERA DRIVE SUITE 300SIOUX FALLSSD57108SHARED SERVICES3575868
AEGIS THERAPIES INC
PO BOX 8103FORT SMITHAR72902PHYSICAL AND OCCUPATIONAL THERAPY245173
TREVOR A MEANEY
948 KIPPES COVEMITCHELLSD57301MIO SERVICES148289
PHYSICIANS LABORATORY
1000E 21ST ST SUITE 4100SIOUX FALLSSD57117PATHOLOGISTS133771
HEARING PLUS
417 N MAIN 105MITCHELLSD57301SPEECH THERAPY107134
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Related Organizations100654RelatedOrganizations
All Other Contributions1159334AllOtherContributions
Total Contributions1259988TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT & RESIDENT6230008073931180739311
OTHER REVENUE90009912804921280492
CAFETERIA900099451854451854
INTEREST IN AVERA HEAL900099414265414265
COMMUNITY WELLNESS9000999920999209
FieldValueIRS element (for citing)
Total Program Service Revenue82985131TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column71911TotalRevenueColumn
Exclusion$71,911ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real459929Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real542736Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-82807Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-82807TotalRevenueColumn
Exclusion-$82,807ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1252075Securities
Other5567Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1252075Securities
Other5567Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1257642TotalRevenueColumn
Exclusion$1,257,642ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column85491865TotalRevenueColumn
Related Or Exempt Function Income82985131RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,246,746ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total163174Total
Program Services163174ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total627718Total
Program Services422698ProgramServices
Management And General205020ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total36586030Total
Program Services29705425ProgramServices
Management And General6852449ManagementAndGeneral
Fundraising28156Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2090566Total
Program Services1698604ProgramServices
Management And General390269ManagementAndGeneral
Fundraising1693Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5653693Total
Program Services4580089ProgramServices
Management And General1069051ManagementAndGeneral
Fundraising4553Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2271996Total
Program Services1839862ProgramServices
Management And General430316ManagementAndGeneral
Fundraising1818Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1430Total
Management And General1430ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5997559Total
Program Services2561555ProgramServices
Management And General3436004ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total388236Total
Program Services35309ProgramServices
Management And General346447ManagementAndGeneral
Fundraising6480Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14178447Total
Program Services12259482ProgramServices
Management And General1913107ManagementAndGeneral
Fundraising5858Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total172676Total
Program Services172676ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1844286Total
Program Services1228747ProgramServices
Management And General615539ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total209103Total
Program Services137700ProgramServices
Management And General71019ManagementAndGeneral
Fundraising384Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total104337Total
Program Services29290ProgramServices
Management And General75047ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total771815Total
Program Services771815ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4048638Total
Program Services4048638ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total715535Total
Program Services715535ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE23842642384264
EQUIPMENT LEASE AND REN1403171383811936
GRANT PROGRAM EXPENDITU9511195111
SALES TAX AND LICENSES48364420146350

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1087988Total
Program Services1081746ProgramServices
Management And General6242ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total79581283Total
Program Services64112115ProgramServices
Management And General15420226ManagementAndGeneral
Fundraising48942Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3760652BOY
EOY3286441EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7766BOY
EOY639EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11822556BOY
EOY11706690EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY146041BOY
EOY108959EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY439315BOY
EOY332077EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1429864BOY
EOY1222612EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY374967BOY
EOY653214EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis85847172LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec47550668LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY38824976BOY
EOY38296504EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY992846BOY
EOY7237868EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY36308275BOY
EOY41750866EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1494449BOY
EOY1228431EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY95601707BOY
EOY105824301EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5787890BOY
EOY6928998EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY458487BOY
EOY128877EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY22388204BOY
EOY22262117EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY561013BOY
EOY544037EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3103259BOY
EOY2925943EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY32298853BOY
EOY32789972EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY61096999BOY
EOY70490116EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1412272BOY
EOY1748895EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY793583BOY
EOY795318EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY63302854BOY
EOY73034329EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY95601707BOY
EOY105824301EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5910582ReconcilationRevenueExpenses
Reconcilation Other Changes3820893ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$11,839GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB11839TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance793583BeginningOfYearBalance
Investment Earnings Or Losses131273InvestmentEarningsOrLosses
End Of Year Balance924856EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1032880BeginningOfYearBalance
Investment Earnings Or Losses-239297InvestmentEarningsOrLosses
End Of Year Balance793583EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1028163BeginningOfYearBalance
Investment Earnings Or Losses4717InvestmentEarningsOrLosses
End Of Year Balance1032880EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.14000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.86000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1109295InvestmentCostOrOtherBasis
Other Cost Or Other Basis1164024OtherCostOrOtherBasis
Book Value2273319BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis50179690OtherCostOrOtherBasis
Depreciation24777545Depreciation
Book Value25402145BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis31684898OtherCostOrOtherBasis
Depreciation21643535Depreciation
Book Value10041363BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1709265OtherCostOrOtherBasis
Depreciation1129588Depreciation
Book Value579677BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings38296504TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN AFFILIATED ORGANIZATIONS262853C
INTEREST IN AVERA HEALTH FOUNDATION2295037F
INTEREST IN NET ASSETS OF MABEE TRUST809145F
ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS38383831F
FieldValueIRS element (for citing)
Total Of Book Value Securities41750866TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DERIVATIVE LIABILITY$1,845,240
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$783,966
CAPITAL LEASE OBLIGATIONS$296,737
FieldValueIRS element (for citing)
Total Of Amounts2925943TotalOfAmounts
Total Revenue85491865TotalRevenue
Total Expenses79581283TotalExpenses
Excess Or Deficit For Year5910582ExcessOrDeficitForYear
Net Unrealized GL On Investments3755885NetUnrealizedGLOnInvestments
Other$65,008OtherAmount
Total Adjustments3820893TotalAdjustments
Excess Or Deficit Per FS9731475ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt88349916TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3755885NetUnrealizedGainsInvestments
Other Revenues224999OtherRevenues
Revenue Not Rptd F9903980884RevenueNotRptdF990
Revenue Subtotal84369032RevenueSubtotal
Other Revenues Not Included1122833OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1122833RevenueNotRptdOnFinStmt
Total Revenue Per Form99085491865TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt79581283TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal79581283ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99079581283TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 2B:THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS RESIDENTS.
PART V, LINE 4:THE ORGANIZATION'S ENDOWMENTS CONSIST OF A PORTION OF THEIR INTEREST IN THE NET ASSETS OF AVERA HEALTH FOUNDATION AND THEIR BENEFICIAL INTEREST IN THE MABEE TRUST. AVERA HEALTH FOUNDATION INCLUDES ENDOWMENT FUNDS WHICH HAVE BEEN ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT FUND ASSETS INCLUDED IN THE ORGANIZATION'S BENEFICIAL INTEREST IN THE MABEE TRUST HAVE BEEN ESTABLISHED TO PURCHASE EQUIPMENT AND FURNISHINGS FOR THE ORGANIZATION. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS (IF ANY), ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ORGANIZATION'S PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE DONOR RESTRICTED. THE ORGANIZATION CURRENTLY DOES NOT HAVE ANY BOARD-DESIGNATED ENDOWMENT FUNDS.DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X: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 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.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
CAPITAL CONTRIBUTIONS, NET -129,511. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 308,019. LOSS ON REFINANCING -22,511. CHANGE IN ACCOUNTING PRINCIPLE -90,989.PART XI, LINE 8 - OTHER ADJUSTMENTS:
CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 308,019. LOSS ON REFINANCING -22,511. RECLASSIFICATION OF ACCUMULATED LOSSES ON INTEREST RATE SWAP -60,509.PART XII, LINE 2D - OTHER ADJUSTMENTS:
GRANTS AND CONTRIBUTIONS RECORDED IN FUND BALANCE FOR FINANCIAL STATEMENTS 748,069. CHANGE IN INTEREST IN AVERA FOUNDATION RECORDED IN FUND BALANCE FOR F/S 255,146. CHANGE IN INTEREST IN MABEE TRUST RECORDED IN FUND BALANCE FOR F/S 119,618.PART XII, LINE 4B - OTHER ADJUSTMENTS:

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served237PersonsServed
Total Community Benefit Expense822544TotalCommunityBenefitExpense
Net Community Benefit Expense822544NetCommunityBenefitExpense
Percent Of Total Expense0.01070PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served7091PersonsServed
Total Community Benefit Expense7425354TotalCommunityBenefitExpense
Direct Offsetting Revenue5373132DirectOffsettingRevenue
Net Community Benefit Expense2052222NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served7328PersonsServed
Total Community Benefit Expense8247898TotalCommunityBenefitExpense
Direct Offsetting Revenue5373132DirectOffsettingRevenue
Net Community Benefit Expense2874766NetCommunityBenefitExpense
Percent Of Total Expense0.03730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs36NumberOfActivitiesOrPrograms
Persons Served71654PersonsServed
Total Community Benefit Expense52495TotalCommunityBenefitExpense
Direct Offsetting Revenue475DirectOffsettingRevenue
Net Community Benefit Expense52020NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served4PersonsServed
Total Community Benefit Expense6043TotalCommunityBenefitExpense
Net Community Benefit Expense6043NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs48NumberOfActivitiesOrPrograms
Persons Served45370PersonsServed
Total Community Benefit Expense152915TotalCommunityBenefitExpense
Net Community Benefit Expense152915NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs85NumberOfActivitiesOrPrograms
Persons Served117028PersonsServed
Total Community Benefit Expense211453TotalCommunityBenefitExpense
Direct Offsetting Revenue475DirectOffsettingRevenue
Net Community Benefit Expense210978NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs85NumberOfActivitiesOrPrograms
Persons Served124356PersonsServed
Total Community Benefit Expense8459351TotalCommunityBenefitExpense
Direct Offsetting Revenue5373607DirectOffsettingRevenue
Net Community Benefit Expense3085744NetCommunityBenefitExpense
Percent Of Total Expense0.04010PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served500PersonsServed
Total Community Building Expense2737TotalCommunityBuildingExpense
Net Community Building Expense2737NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served350PersonsServed
Total Community Building Expense3508TotalCommunityBuildingExpense
Net Community Building Expense3508NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served518PersonsServed
Total Community Building Expense56192TotalCommunityBuildingExpense
Net Community Building Expense56192NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served244PersonsServed
Total Community Building Expense1902TotalCommunityBuildingExpense
Net Community Building Expense1902NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served1612PersonsServed
Total Community Building Expense64339TotalCommunityBuildingExpense
Net Community Building Expense64339NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$979,933BadDebtExpenseAmount
Amount Reimbursed By Medicare24750473AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare33664494CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8914021MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOtherCritical Access HospitalCriticalAccessHospital
AVERA QUEEN OF PEACE HOSPITAL
1525 NORTH FOSTER STREETMITCHELLSD57301XXX3 PROVIDER BASED CLINICS
AVERA WESKOTA MEMORIAL MEDICAL CENTER
2609 1ST STREET NEWESSINGTON SPRINGSSD57382XXX
AVERA DE SMET MEMORIAL HOSPITAL
3306 PRAIRIE AVENUE SWDE SMETSD57231XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
AVERA BRADY ASSISTED LIVING
1414 W CEDAR AVEMITCHELLSD57301ASSISTED LIVING
AVERA BRADY HEALTH AND REHAB
500 S OHMAN STMITCHELLSD57301NURSING HOME

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation
PART I, LINE 3C: TO DETERMINE ELIGIBILITY FOR CHARITY CARE, AVERA QUEEN OF PEACE HOSPITAL HAS DEVELOPED A TEST WHICH UTILIZES A COMBINATION OF HOUSEHOLD INCOME, HOUSEHOLD ASSETS, AND ALSO CONSIDERS UNPAID PAST AND ONGOING MEDICAL EXPENSES. CHARITY DISCOUNT MAY RANGE FROM 0 - 100% DEPENDING ON SCORE.
PART I, LINE 6A: PART 1, 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 AND UNREIMBURSED MEDICAID WAS CONVERTED TO COST USING THE COST TO CHARGE RATIO IN IRS WORKSHEET 2. THE AMOUNTS ON LINES 7E-I REPRESENT EXPENSES REPORTED IN THE GENERAL LEDGER.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES COSTS OF $1,336,019 RELATED TO RURAL HEALTH CLINICS.
PART I, L7 COL(F): AQOP BAD DEBT EXPENSE OF $2,484,698 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
PART II: AVERA QUEEN OF PEACE SUPPORTS NUMEROUS ECONOMIC DEVELOPMENT ORGANIZATIONS WITH PARTICIPATION AT MEETINGS AND DONATIONS THROUGHOUT ITS SERVICE AREA. ADDITIONALLY, AVERA QUEEN OF PEACE WORKS WITH DAKOTA WESLEYAN UNIVERSITY, THE MITCHELL TECHNICAL INSTITUTE, AND LOCAL HIGH SCHOOLS TO ADDRESS HEALTHCARE WORKER SHORTAGES IN THE COMMUNITIES OF ITS SERVICE AREA.
PART III, LINE 4: BAD DEBT WAS CONVERTED TO COST USING THE COST TO CHARGE RATIO DERIVED FROM IRS WORKSHEET 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. NOTE FROM FINANCIAL STATEMENT:PATIENT AND RESIDENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT, RESIDENT AND THIRD-PARTY PAYOR OBLIGATIONS. PAYMENTS OF PATIENT AND RESIDENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM.THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. MANAGEMENT ALSO REVIEWS ACCOUNTS TO DETERMINE IF CLASSIFICATION AS CHARITY CARE IS APPROPRIATE.
PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. AVERA QUEEN OF PEACE FOLLOWS THE CHA GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL (AS CALCULATED INCLUDING OUR NON-COST REPORT ENTITIES) IS EXCLUDED FROM OUR COMMUNITY BENEFIT REPORT. HOWEVER, MEDICARE IS THE ORGANIZATION'S LARGEST PAYER AND PATIENTS WITH MEDICARE COVERAGE ARE ACCEPTED REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED FROM PROVIDING THE SERVICES. THIS BASIS THEREFORE MEANS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A KEY ADVANTAGE FOR OUR COMMUNITY.
PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE ORGANIZATION OR IT'S AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE AGENCY IF DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT. AT SUCH TIME AS THE ORGANIZATION SENDS THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY SHALL REFLECT THE REDUCED-PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. ANY EXTENDED PAYMENT PLANS OFFERED BY A HOSPITAL IN SETTLING THE OUTSTANDING BILLS OF LOW INCOME, UNINSURED PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENTS OCCUR AT VARIOUS LOCATIONS THROUGHOUT THE AVERA QUEEN OF PEACE REGION AND AVERA HEALTH SYSTEM. ANNUAL BOARD PLANNING SESSIONS TAKE PLACE AT ALL FACILITIES IN THE AVERA QUEEN OF PEACE REGION. BOARD MEMBERS AND OTHER COMMUNITY LEADERS REVIEW AND DISCUSS SUCCESSES, CHALLENGES, AND SERVICE GAPS IN THEIR COMMUNITIES. NEEDS ARE IDENTIFIED AND RESOURCES DIRECTED TO ADDRESS THESE NEEDS.
PART VI, LINE 3: PRINTED NOTICES ARE POSTED 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 ON THE ADMISSION AUTHORIZATION FORM AND PATIENT INFORMATION BOOKLETS IN ALL HOSPITAL PATIENT ROOMS. A BROCHURE ENTITLED: "MANAGING YOUR HEALTH CARE EXPENSES" IS PROVIDED TO ALL SELF-PAY PATIENTS. THE AQOP 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: THE PRIMARY SERVICE AREA OF AVERA QUEEN OF PEACE HOSPITAL CONSISTS OF THE COUNTIES OF DAVISON, AURORA, HANSON, AND SANBORN. THE 2010 CENSUS LISTED A TOTAL POPULATION OF 27,900 WITHIN THESE FOUR COUNTIES. AVERA QUEEN OF PEACE HAS A SECONDARY SERVICE AREA OF 18 VERY RURAL COUNTIES SURROUNDING THE PRIMARY SERVICE AREA.
PART VI, LINE 6: AVERA QUEEN OF PEACE IS A VERIFIED LEVEL III TRAUMA CENTER AND OPERATES AN EMERGENCY DEPARTMENT STAFFED 24 HOURS PER DAY WITH BOARD CERTIFIED PHYSICIANS. EMERGENCY CARE IS PROVIDED ON AN OPEN DOOR BASIS REGARDLESS OF ABILITY TO PAY.AVERA QUEEN OF PEACE LEASES OR MANAGES THREE CRITICAL ACCESS HOSPITALS WHICH PROVIDE A BROAD RANGE OF INPATIENT, OUTPATIENT SERVICES AND 24 HOUR EMERGENCY ROOMS IN 3 VERY RURAL COMMUNITIES.AVERA QUEEN OF PEACE OWNS THREE RURAL HEALTH CLINICS WHICH PROVIDE PRIMARY CARE SERVICES IN THREE RURAL COMMUNITIES. SIMILAR TO THE HOSPITALS IN THE AQOP REGION, THESE CLINICS ARE OPERATED ON AN OPEN DOOR BASIS AND CARE IS PROVIDED REGARDLESS OF ABILITY TO PAY.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL LICENSED AND QUALIFIED APPLICANTS. THE AVERA QUEEN OF PEACE BOARD OF DIRECTORS IS PRINCIPALLY COMPRISED OF COMMUNITY MEMBERS FROM THE PRIMARY AND SECONDARY SERVICES AREAS. MEMBERS COME FROM A VARIETY OF BACKGROUNDS INCLUDING BANKING, EDUCATION, AGRICULTURE, HEALTHCARE, AND PRIVATE INDUSTRY.
PART VI, LINE 7: 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

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
MITCHELL CHARITABLE FOUNDATION
PO BOX 1366MITCHELLSD57301460390971501(C)(3)5000DONATION
MITCHELL TECH INSTITUTE FOUNDATION
821 N CAPITALMITCHELLSD57301460452950501(C)(3)45000DONATION
UNIVERSITY OF SOUTH DAKOTA
414 E CLARK STVERMILLIONSD57069466018891501(C)(3)24000DONATION
ABBOTT HOUSE INC
909 COURT MERRILLMITCHELLSD57301460229822501(C)(3)DONATION21793PURCHASE PRICEEXERCISE EQUIPMENT
MITCHELL AREA DEVELOPMENT CORPORATION
610 N MAIN STMITCHELLSD57301460394983501(C)(3)10000DONATION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION ONLY MAKES GRANTS TO OTHER ORGANIZATIONS WHICH ARE TAX-EXEMPT UNDER SECTION 501(C)(3).Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT SNORTUM MD
296330038849040380137780205790373574000
TOM RASMUSSON
044951600013674012250019998049543800
PATRICK J CLARK
18289803715805018010616088050244495000
JEROME HOWE MD
17862403932510432770115000158060642458000
CHRISTOPHER KROUSE MD
875753015114707844401150001786301134707000
MICHAEL HALEY MD
19067404603150383490115000216680722506000
DENNIS LELAND MD
19467905010170330710115000176620757929000
BRIAN KAMPMANN MD
5429490365940521810115000184420661666000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSCHEDULE J, PART I LINE 3: THE PRESIDENT/CEO'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, AVERA HEALTH. AVERA QUEEN OF PEACE RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT/CEO USING THE METHODS DESCRIBED IN PART I, LINE 3.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
CHRISTOPHER KROUSE
RECRUITMENTX$340,00056022011
BRIAN KAMPMANN
RECRUITMENTX$136,00052937011
FieldValueIRS element (for citing)
Total Balance Due108959TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2SISTER KATHLEEN CROWLEY HAS A BUSINESS RELATIONSHIP WITH TOM RASMUSSON.
FORM 990, PART VI, SECTION A, LINE 6THE 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 7AAVERA 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 7BAVERA 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 11THE RETURN IS REVIEWED INITIALLY BY THE CFO. THE RETURN IS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. AT EACH BOARD MEETING, A REQUEST IS MADE FOR ALL BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST PERTAINING TO ANY ITEM LISTED ON THE AGENDA OR PERTAINING TO ANY POTENTIAL ITEM THAT COULD BE DISCUSSED DURING THE COURSE OF THE MEETING. THE DECLARATION OF CONFLICT OF INTEREST IS RECORDED IN THE MEETING MINUTES. THE BOARD MAKES A DETERMINATION OF WHETHER THERE IS A CONFLICT OF INTEREST AND IF SO, IMPLEMENTS THE PROCEDURE FOR EVALUATING THE ISSUE OR TRANSACTION INVOLVED. THE BOARD MEMBER OR OFFICER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND DIRECTORS. THE INFORMATION IS MAINTAINED IN A DATABASE AND A REPORT IS PROVIDED TO THE BOARD.FORM 990, PART VI, SECTION B, LINE 12C
FORM 990, PART VI, SECTION B, LINE 15: THE CEO IS COMPENSATED BY AVERA HEALTH. ANNUALLY THE COMPENSATION COMMITTEE OF AVERA HEALTH, WHICH IS COMPRISED OF SIX (6) SYSTEM MEMBERS APPOINTED BY THE RELIGIOUS ORDERS, MEETS WITH AN INDEPENDENT CONSULTANT REGARDING FAIR MARKET VALUE OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE APPROVES ALL SALARIES BASED ON COMPARABLE DATA AND DOCUMENTS THE BASIS FOR THEIR DECISION IN MEETING MINUTES. THE COMPENSATION OF THE SENIOR VP OF FINANCE IS DETERMINED BY HUMAN RESOURCES BASED ON A MARKET ANALYSIS OF COMPARABLE POSITIONS. THE COMPENSATION IS APPROVED BY THE CEO.
THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE ARE AVAILABLE TO THE GENERAL PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
IN ADDITION TO THE HOURS SERVED AT AVERA QUEEN OF PEACE HOSPITAL, SISTER KATHLEEN CROWLEY ALSO SERVES 1 HOUR PER WEEK AT BOTH AVERA WORKERS' COMPENSATION TRUST AND AVERA HOLY FAMILY AND 5 HOURS PER WEEK AT AVERA HEALTH. SISTER LYNN MARIE WELBIG SERVES AN ADDITIONAL 2 HOURS PER WEEK AT SACRED HEART HEALTH SERVICES.FORM 990, PART VII:
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 3,755,885. CAPITAL CONTRIBUTIONS, NET -129,511. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 308,019. LOSS ON REFINANCING -22,511. CHANGE IN ACCOUNTING PRINCIPLE -90,989. TOTAL TO FORM 990, PART XI, LINE 5: 3,820,893.FORM 990, PART XI, LINE 5:
THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA QUEEN OF PEACE.FORM 990, PART XII, LINE 2C:
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 MCKENNAN, AVERA ST. LUKE'S, AVERA QUEEN OF PEACE, AND AVERA SACRED HEART. IN ACCORDANCE WITH IRS INSTRUCTIONS, INFORMATION RELATED TO THE TAX EXEMPT BOND REPORTING IS BEING REPORTED ON AVERA HEALTH'S TAX RETURN (EIN 46-0422673).FORM 990, PART X, LINE 20:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
AVERA HEALTH
3900 WEST AVERA DRIVE SUITE 300SIOUX FALLSSD57108460422673PROMOTION OF HEALTHSD501(C)(3)LINE 9N/A0
AVERA WORKERS' COMPENSATION TRUST
3900 WEST AVERA DRIVESIOUX FALLSSD57108460407148ECONOMICAL COVERAGE OF WORKERS' COMPENSATION CLAIMSSD501(C)(3)LINE 11B, II0AVERA HEALTH
AVERA ST ANTHONY'S HOSPITAL
300 N 2ND STREETONEILLNE68763470463911HEALTHCARE EDUCATIONNE501(C)(3)LINE 30AVERA HEALTH
AVERA HOLY FAMILY
826 NORTH 8TH STREETESTHERVILLEIA51334420680370HEALTHCARE SERVICESIA501(C)(3)LINE 30AVERA HEALTH
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREETESTHERVILLEIA51334421317452FUNDRAISINGIA501(C)(3)LINE 90AVERA HOLY FAMILY
AVERA MARSHALL
300 S BRUCE STREETMARSHALLMN56258410919153HEALTHCARE SERVICESMN501(C)(3)LINE 30AVERA HEALTH
AVERA MARSHALL FOUNDATION
300 S BRUCE STREETMARSHALLMN56258411784801FUNDRAISINGMN501(C)(3)LINE 70AVERA MARSHALL
ST BENEDICT HEALTH CENTER
401 WEST GLYNN DRIVEPARKSTONSD57366460226738HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
ST BENEDICT HEALTH CENTER FOUNDATION
WEST GLYNN DRIVE PO BOX BPARKSTONSD57366460458725SUPPORT HEALTH RELATED SERVICESSD501(C)(3)LINE 11A, I0ST BENEDICT HEALTH CENTER
AVERA MCKENNAN
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117460224743HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
SACRED HEART HEALTH SERVICES
501 SUMMIT STREETYANKTONSD57078460225483HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH
SACRED HEART RURAL HEALTH CLINICS INC
501 SUMMIT STREETYANKTONSD57078460423930CLINIC SERVICESSD501(C)(3)LINE 30SACRED HEART HEALTH SERVICES
HEALTH MANAGEMENT SERVICES
501 SUMMITYANKTONSD57078460399291ADULT DAYCARE AND HOMEMAKING SERVICESSD501(C)(3)LINE 90SACRED HEART HEALTH SERVICES
LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY
1000 W 4TH STREET SUITE 9YANKTONSD57078460337013HEALTHCARE SERVICESSD501(C)(3)LINE 90SACRED HEART HEALTH SERVICES
AVERA ST LUKE'S
305 SOUTH STATE STREETABERDEENSD57401460224598HEALTHCARE SERVICESSD501(C)(3)LINE 30AVERA HEALTH

Form990 Schedule R Part III Form990ScheduleRPartIII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Q&M PROPERTIES LLC
525 NORTH FOSTERMITCHELLSD57301731652049MEDICAL CLINIC BUILDINGSDN/AEXCLUDED - SEC 512-15277426344010.50000
AVERA HOME MEDICAL EQUIPMENT LLC
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117460488198MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
MIDWEST REGIONAL IMAGING SERVICES LLC
1325 S CLIFF AVE PO BOX 5045SIOUX FALLSSD57117470874983HEALTH CARE - MEDICAL IMAGINGSDN/A
MERSCO MEDICAL OF PIERRE LLC
329 E DAKOTAPIERRESD57501460444002MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF FLOYD VALLEY HOSPITAL LLC
714 LINCOLN ST NELEMARSIA51031820582350MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC
PO BOX 5045SIOUX FALLSSD57117201686097MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC
38 19TH ST SWSIOUX CENTERIA51250753203100MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC
1104 EAST COLLEGE DRIVEMARSHALLMN56258205271924MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVE 102SIOUX FALLSSD57117800619999MEDICAL SERVICES - HOME MEDICAL EQUIPMENTSDN/A
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA STABERDEENSD57401460461429SURGICAL ASSOCIATESSDN/A
HEART HOSPITAL OF SOUTH DAKOTA LLC
10720 SIKES PLACE SUITE 300CHARLOTTENC28277562143771HEALTHCARE SERVICESNCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
ACCOUNTS MANAGEMENT INC
5132 S CLIFF AVE SUITE 101SIOUX FALLSSD57108460373021COLLECTION AGENCYSDN/AC
AVERA HEALTH PLANS INC
3900 WEST AVERA DRIVE SUITE 101SIOUX FALLSSD57108460451539HEALTH FINANCING AND HEALTH PLAN ADMINISTRATIONSDN/AC
AVERA PROPERTY INSURANCE INC
610 W 23RD ST STE 1 PO BOX 38YANKTONSD57078460463155INSURANCESDN/AC
DR DONALD & MARGUERITE MABEE TRUST
C/O FIRST NATIONAL BANK OF SOUTH DAMITCHELLSD57301466056202INVESTINGSDN/AT1196188091451.00000
VALLEY HEALTH SERVICES
501 SUMMIT STREETYANKTONSD57078460357149MEDICAL EQUIPMENTSDN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1DR DONALD & MARQUERITE MABEE TRUSTBusinessNameLine1