Civic Intelligence

Avera Health

990 • Fiscal year 2017 • EIN 46-0422673

Jul 01, 2016 to Jun 30, 2017 • Filed on May 10, 2018

3900 WEST AVERA DRIVE No 300Sioux Falls, SD 57108

(605) 322-7300

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

86th percentile

0.71x

Higher debt load relative to assets than 86% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Liabilities / Revenue

89th percentile

3.45x

Higher debt load relative to revenue than 89% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Net Margin

63rd percentile

11%

Higher net margin than 63% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Top Officer Pay

48th percentile

$1,708,847

Higher top officer pay than 48% of similar nonprofits.

Top officer pay equals 0.8% of source-year revenue.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Asset Growth

2nd percentile

-19%

Faster asset growth than 2% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2016 to 2017

Revenue Growth

73rd percentile

14%

Faster revenue growth than 73% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2016 to 2017

Assets

Down

$1,067,436,720

Down $250,247,051 (-19%) from 2016

Net Assets

Up

$312,158,082

Up $38,573,221 (+14%) from 2016

Liabilities

Down

$755,278,638

Down $288,820,272 (-28%) from 2016

Revenue

Up

$218,893,740

Up $27,452,540 (+14%) from 2016

Expenses

Up

$195,715,801

Up $24,323,514 (+14%) from 2016

Net Income

Up

$23,177,939

Up $3,129,026 (+16%) from 2016

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$3.0B$2.0B$1.0B$0Assets 2010: $570,136,185Liabilities 2010: $441,702,144Net Assets 2010: $128,434,0412010Assets 2011: $700,195,823Liabilities 2011: $523,220,103Net Assets 2011: $176,975,7202011Assets 2012: $1,060,451,267Liabilities 2012: $894,626,647Net Assets 2012: $165,824,6202012Assets 2013: $1,156,273,576Liabilities 2013: $944,979,987Net Assets 2013: $211,293,5892013Assets 2014: $1,372,317,642Liabilities 2014: $1,121,323,279Net Assets 2014: $250,994,3632014Assets 2015: $1,372,841,956Liabilities 2015: $1,111,615,665Net Assets 2015: $261,226,2912015Assets 2016: $1,317,683,771Liabilities 2016: $1,044,098,910Net Assets 2016: $273,584,8612016Assets 2017: $1,067,436,720Liabilities 2017: $755,278,638Net Assets 2017: $312,158,0822017Assets 2018: $1,282,022,027Liabilities 2018: $978,667,960Net Assets 2018: $303,354,0672018Assets 2019: $1,324,107,753Liabilities 2019: $1,014,353,811Net Assets 2019: $309,753,9422019Assets 2020: $1,513,047,085Liabilities 2020: $1,166,092,281Net Assets 2020: $346,954,8042020Assets 2021: $1,761,941,902Liabilities 2021: $1,374,402,196Net Assets 2021: $387,539,7062021Assets 2022: $1,756,534,821Liabilities 2022: $1,298,038,269Net Assets 2022: $458,496,5522022Assets 2023: $1,738,162,649Liabilities 2023: $1,435,789,048Net Assets 2023: $302,373,6012023Assets 2024: $2,306,128,147Liabilities 2024: $1,968,523,287Net Assets 2024: $337,604,8602024

Highlighted filing

2017

Assets$1,067,436,720
Liabilities$755,278,638
Net Assets$312,158,082

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$600M$400M$200M$0-$200MExpenses 2010: $42,928,9962010Expenses 2011: $63,291,8012011Expenses 2012: $74,131,3652012Expenses 2013: $87,622,9862013Revenue 2014: $134,809,969Expenses 2014: $119,455,600Net Income 2014: $15,354,3692014Revenue 2015: $169,384,234Expenses 2015: $150,100,505Net Income 2015: $19,283,7292015Revenue 2016: $191,441,200Expenses 2016: $171,392,287Net Income 2016: $20,048,9132016Revenue 2017: $218,893,740Expenses 2017: $195,715,801Net Income 2017: $23,177,9392017Revenue 2018: $225,457,103Expenses 2018: $234,897,798Net Income 2018: -$9,440,6952018Revenue 2019: $273,884,389Expenses 2019: $270,833,675Net Income 2019: $3,050,7142019Revenue 2020: $295,600,192Expenses 2020: $266,728,621Net Income 2020: $28,871,5712020Revenue 2021: $323,568,990Expenses 2021: $333,143,247Net Income 2021: -$9,574,2572021Revenue 2022: $441,737,044Expenses 2022: $292,380,913Net Income 2022: $149,356,1312022Revenue 2023: $285,338,511Expenses 2023: $291,882,361Net Income 2023: -$6,543,8502023Revenue 2024: $278,424,080Expenses 2024: $280,386,542Net Income 2024: -$1,962,4622024

Highlighted filing

2017

Revenue$218,893,740
Expenses$195,715,801
Net Income$23,177,939
Jump To
Filing Snapshot
Filing Period
Jul 1, 2016 to Jun 30, 2017
Signed
May 10, 2018
Return Version
2016v3.0
Gross Receipts
$221,045,858
Mission and Program Overview

Mission

Avera Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

Promotion of Health

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$678,919,195$755,017,402▲ $76,098,207
Investments Other Securities$137,216,010$156,100,597▲ $18,884,587
Land, Buildings, and Equipment, Net$96,593,254$102,696,792▲ $6,103,538
Intangible Assets$16,139,552$16,139,552→ $0
Accounts Receivable$9,231,068$11,520,461▲ $2,289,393
Prepaid Expenses and Deferred Charges$6,099,852$7,678,449▲ $1,578,597
Other Notes and Loans Receivable, Net$4,974,471$4,750,610▼ $223,861
Savings and Temporary Cash Investments$7,219,487$2,587,101▼ $4,632,386
Inventories for Sale or Use$180,711$962,367▲ $781,656
Pledges and Grants Receivable$872,897$819,321▼ $53,576
Investments Program Related$43,432$33,615▼ $9,817
Total Assets$1,018,218,771$1,067,436,720▲ $49,217,949
Other Assets Total$60,728,842$9,130,453▼ $51,598,389
Liabilities
Escrow Account Liability$583,975,073$645,715,791▲ $61,740,718
Other Liabilities$39,560,498$41,595,037▲ $2,034,539
Mortgage Notes Payable Secured by Investment Property$83,517,570$30,823,538▼ $52,694,032
Accounts Payable and Accrued Expenses$20,996,814$20,592,416▼ $404,398
Tax Exempt Bond Liabilities$10,394,733$10,473,243▲ $78,510
Deferred Revenue$6,189,222$6,078,613▼ $110,609
Total Liabilities$744,633,910$755,278,638▲ $10,644,728
Net Assets / Fund Balance
Unrestricted Net Assets$269,879,457$308,992,474▲ $39,113,017
Temporarily Rstr Net Assets$3,189,652$2,720,423▼ $469,229
Permanently Rstr Net Assets$515,752$445,185▼ $70,567
Total Net Assets Fund Balance$273,584,861$312,158,082▲ $38,573,221
Total Liabilities and Net Assets / Fund Balance$1,018,218,771$1,067,436,720▲ $49,217,949

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$47,379,075$50,728,044$98,107,119
Buildings$22,306,207$7,438,658$29,744,865
Other Land Buildings$16,556,557-$16,556,557
Leasehold Improvements$1,962,318$2,025,687$3,988,005
Land$14,492,635-$948,600
Other Securities$12,491,409--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2016$4,854,052$583,639▲ $147,566$548,377$5,004,011
2015$4,361,194$413,851▲ $391,376$277,515$4,854,052
2014$3,542,771$367,555▲ $782,973$296,350$4,361,194
2013$3,302,432$477,896▲ $155,637$370,880$3,542,771
2012$6,046,321$328,355▲ $656,901$3,729,145$3,302,432
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
John PorterPresident & CEOFT$1,213,711$495,136$1,708,847
Fredrick SluneckaChief Operating OfficerFT$857,381$338,021$1,195,402
David KapaskaPres/CEO-McKennan-$680,086$275,370$955,456
James BreckenridgeSec/Treas & SrVP FinanceFT$627,758$259,946$887,704
David EricksonSr VP Medical AffairsFT$553,781$187,745$741,526
Todd ForkelPres/CEO-St. Luke's-$488,898$206,028$694,926
David FlicekChief Administrative OfficerFT$484,384$164,606$648,990
Richard KormanSenior VP - General Counsel-$454,445$170,129$624,574
James VelineSenior VP - CIO-$410,676$175,211$585,887

Highest Paid Contractors

ContractorServicesLocationCompensation
CDW GovernmentComputer Hardware Consulting230 N Milwaukee Ave, Vernon Hills, IL 60061$16,776,538
Avera McKennanServices, computer hardware & software1325 S Cliff Avenue, Sioux Falls, SD 57117$9,525,769
ElektaComputer Hardware/Software/Consulting/Ca400 Perimeter Center Terrace Suite, Atlanta, GA 30346$4,057,292
MedspeedCourier Services655 West Grand Avenue, Elmhurst, IL 60126$3,529,604
Medical Information TechnologyHardware/Software Consulting1 Meditech Circle, Westwood, MA 02090$3,313,011
Revenue and Support

Revenue Composition

Contributions and Grants
$15,789,136
Program Service Revenue
$187,050,828
Investment Income
$15,603,501
Other Revenue
$450,275
All Other Contributions
$9,444,121
Change in Net Assets
$23,177,939

Noncash Contribution Practices

Property subject to holding requirements
No
Reviewed unusual noncash gifts
Yes
Third parties used for noncash contributions
Yes

Noncash Contributions

Contribution TypeContribution CountReported AmountValuation Method
Securities Publicly Traded14$326,664Avg of high/low
Real Estate Other1$95,000Amount over Fair Market Value (FMV) of land
Other Non Cash Contri Table4$34,000cost
Other Non Cash Contri Table1$15,750cost
Other Non Cash Contri Table1$12,000cost
Other Non Cash Contri Table1$7,000cost
Other Non Cash Contri Table1$6,900cost
Other Non Cash Contri Table1$5,000cost
Other Non Cash Contri Table1$5,000cost
Other Non Cash Contri Table1$1,650cost
Other Non Cash Contri Table1$1,000cost
Other Non Cash Contri Table1$900cost
Other Non Cash Contri Table1$465cost
Other Non Cash Contri Table1$425cost
Other Non Cash Contri Table1$140cost
Other Non Cash Contri Table1$34cost
Total Noncash Contributions32$511,928-
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$110,023,045
Other Expenses$79,902,077
Grants and Similar Amounts Paid$5,790,679
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$73,976,200$6,964,797-$80,940,997
Fees for Services Other$28,365,946$5,643,215-$34,009,161
Depreciation Depletion$15,840,577$823,522-$16,664,099
Other Employee Benefits$11,274,395$2,296,230-$13,570,625
Advertising$6,590,618$3,718-$6,594,336
Office Expenses$5,359,916$379,140-$5,739,056
Pension Plan Contributions$5,127,625$539,804-$5,667,429
Grants to Domestic Orgs$5,651,134--$5,651,134
Payroll Taxes$4,811,840$455,570-$5,267,410
Information Technology$5,114,222$15,132-$5,129,354
Current Officers, Directors, Trustees, and Key Employees-$4,576,584-$4,576,584
Occupancy$3,019,814$298,957-$3,318,771
Travel$1,677,811$131,117-$1,808,928
Fees for Services Accounting$773,833$432,778-$1,206,611
Conferences and Meetings$1,122,517$68,102-$1,190,619
All Other Expenses$791,503$188,764-$980,267
Interest-$781,202-$781,202
Insurance$117,310$96,822-$214,132
Grants to Domestic Individuals$139,545--$139,545
Fees for Services Legal-$65,166-$65,166
Other Expenses$539,782$-13,410-$-13,410
Total Functional Expenses$171,962,134$23,753,667$0$195,715,801
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
South Dakota State UniversityBrookings, SD501(c)(3)Sponsorship$1,528,000
Sioux Falls Catholic SchoolsSioux Falls, SD501(c)(6)Sponsorship$900,000
University of Sioux FallsSioux Falls, SD501(c)(3)Sponsorship$400,000
Forward Sioux FallsSioux Falls, SD501(c)(3)Community Benefit$150,000
Northern State UniversityAberdeen, SD501(c)(19)Sponsorship$150,000
Catholic Community Foundation for Eastern SDSioux Falls, SD501(c)(3)Sponsorship$100,000
Aberdeen Catholic School SystemAberdeen, SD501(c)(3)Sponsorship$93,621
Sioux Empire United WaySioux Falls, SD501(c)(3)Sponsorship$80,000
Yankton Area Progressive GrowthYankton, SD-Sponsorship$60,000
EmBeYWCASioux Falls, SD501(c)(3)Sponsorship$59,000
Washington PavilionSioux Falls, SD-Sponsorship$55,000
Goodwill of the Great PlainsSioux City, IACity of HarrisburgSponsorship$53,141
Special Olympics of South DakotaSioux Falls, SD501(c)(3)Sponsorship$52,500
Friends of Levitt Shell Sioux Falls IncSioux Falls, SD501(c)(3)Sponsorship$50,000
Lutheran Social ServicesSioux Falls, SD501(c)(3)Community Benefit$50,000
Mount Marty CollegeYankton, SD501(c)(6)Sponsorship$50,000
Parkston Area Development CorporationParkston, SD501(c)(3)Community Benefit$50,000
Presentation CollegeAberdeen, SD501(c)(3)Community Benefit$50,000
Yankton County Historical SocietyYankton, SD-Sponsorship$50,000
Mitchell Technical Institute FoundationMitchell, SDState of SDSponsorship$45,000
South Dakota Symphony OrchestraSioux Falls, SD501(c)(3)Sponsorship$41,000
Boys and Girls Club of YanktonYankton, SD501(c)(3)Community Benefit$40,000
Brookings Health SystemBrookings, SD501(c)(3)Sponsorship$35,000
Coalition to Protect American's HealthcareBethesda, MD501(c)(4)Sponsorship$30,000
Dakota Wesleyan UniversityMitchell, SD501(c)(3)Sponsorship$30,000
Feeding South DakotaSioux Falls, SD501(c)(3)Community Benefit$25,000
Harrisburg School DistrictHarrisburg, SD501(c)(3)Sponsorship$25,000
LifeLight Communications IncSioux Falls, SD501(c)(3)Sponsorship$25,000
Sd HosaSioux Falls, SD501(c)(3)Sponsorship$25,000
Ronald McDonald House Charities of South Dakota IncSioux Falls, SD501(c)(3)Community Benefit$20,000
Sioux Falls Jazz & Blues SocietySioux Falls, SD501(c)(3)Sponsorship$20,000
Southeast Tech FoundationSioux Falls, SD501(c)(3)Community Benefit$20,000
Etc for HerSioux Falls, SD501(c)(3)Sponsorship$19,000
Sioux Falls Youth Hockey AssocSioux Falls, SD501(c)(3)Sponsorship$17,500
Washington High SchoolSioux Falls, SD501(c)(3)Sponsorship$17,000
Sioux Empire Baseball AssociationSioux Falls, SD501(c)(3)Sponsorship$16,000
Daktronics IncMinneapolis, MN501(c)(3)Sponsorship$15,000
Destiny Healthcare InternationalSioux Falls, SD501(c)(3)Community Benefit$15,000
Face It Together Sioux FallsSioux Falls, SD501(c)(3)Community Benefit$15,000
Volunteers of AmericaSioux Falls, SD501(c)(6)Sponsorship$15,000
Aberdeen Ride LineAberdeen, SD501(c)(3)Community Benefit$12,960
LifeScape FoundationSioux Falls, SD501(c)(3)Community Benefit$12,500
Dakotabilities IncSioux Falls, SD501(c)(3)Community Benefit$12,000
Family Visitation CenterSioux Falls, SD501(c)(3)Community Benefit$12,000
United Way of Greater YanktonYankton, SD501(c)(3)Community Benefit$12,000
McCrossan Foundation IncSioux Falls, SD501(c)(3)Sponsorship$11,000
Sculpture WalkSioux Falls, SD501(c)(3)Sponsorship$11,000
Aberdeen Christian School IncAberdeen, SD501(c)(3)Sponsorship$10,000
Avera St Mary's FoundationPierre, SD501(c)(3)Sponsorship$10,000
Canton School DistrictCanton, SDCity of CantonSponsorship$10,000
Career & Technical Education AcademySioux Falls, SD501(c)(3)Sponsorship$10,000
Central SD RSVPPierre, SD501(c)(3)Community Benefit$10,000
Pierre Post 8 BaseballPierre, SD501(c)(3)Sponsorship$10,000
Pride in the Tiger FoundationMarshall, MN501(c)(3)Sponsorship$10,000
Safe HarborAberdeen, SD501(c)(3)Community Benefit$10,000
Sioux Center Hospital and Health Center FoundationSioux Center, IA501(c)(3)Community Partnership$10,000
South Dakota Ag & Rural LeadershipBrookings, SDState of SDSponsorship$10,000
Furniture Mission of South DakotaSioux Falls, SD501(c)(3)Community Benefit$8,000
Aberdeen Development CorporationAberdeen, SD501(c)(6)Sponsorship$7,500
Boys and Girls Club of the Sioux EmpireSioux Falls, SD501(c)(3)Community Benefit$7,500
OLLI at University CenterSioux Falls, SDCity of PierreCommunity Benefit$7,500
Philanthropy Promotions IncSioux Falls, SD501(c)(3)Sponsorship$7,500
Sioux Empire Fastpitch Softball AssociationSioux Falls, SD501(c)(3)Sponsorship$7,500
Butterfly House & AquariumSioux Falls, SD501(c)(3)Sponsorship$7,000
Pierre School DistrictPierre, SD501(c)(3)Sponsorship$6,600
Brandon Valley Booster ClubBrandon, SD501(c)(3)Sponsorship$6,500
Charis Ministry PartnersSioux Falls, SD501(c)(3)Community Benefit$6,000
Children's Home Society of South DakotaSioux Falls, SD501(c)(3)Community Benefit$6,000
SME of Sioux FallsSioux Falls, SD501(c)(3)Sponsorship$5,997
Mitchell Area CooperativeMitchell, SD501(c)(3)Sponsorship$5,500
Aberdeen Family Y Foundation IncAberdeen, SD501(c)(3)Community Benefit$5,000
Aberdeen United WayAberdeen, SD501(c)(3)Community Benefit$5,000
Boys and Girls Club of AberdeenAberdeen, SD501(c)(3)Community Benefit$5,000
Capital Area United WayPierre, SD501(c)(3)Community Benefit$5,000
Corn PalaceMitchell, SDCity of Mitchell, SDSponsorship$5,000
Dakota Heartland Development AssociationMitchell, SD501(c)(6)Sponsorship$5,000
Downtown Sioux Falls IncSioux Falls, SD501(c)(4)Sponsorship$5,000
Flandreau High SchoolFlandreau, SD501(c)(3)Sponsorship$5,000
Ground Works MidwestSioux Falls, SD501(c)(3)Community Benefit$5,000
Mitchell United WayMitchell, SD501(c)(3)Community Benefit$5,000
Redwood Area Communities FoundationRedwood Falls, MN501(c)(3)Sponsorship$5,000
Sioux Council Boy Scouts of AmericaSioux Falls, SD501(c)(3)Sponsorship$5,000
Sioux Falls CASASioux Falls, SD501(c)(3)Community Benefit$5,000
South Dakota Golf Association Junior Golf FoundationSioux Falls, SDCity of FlandreauSponsorship$5,000
South Dakota Parks and Wildlife FoundationPierre, SD501(c)(3)Sponsorship$5,000
The BanquetSioux Falls, SD501(c)(3)Community Benefit$5,000
United Way of Southwest MinnesotaMarshall, MNCity of Sioux FallsCommunity Benefit$5,000

International Summary

Offices
0
Employees
0
Spending
$84,314,422

International Compliance

Activity in boycott countries
No
Foreign corporation ownership
No
Foreign partnership interest
No
Interest in foreign trust
No
Passive foreign investment company interest
No
Transfers to foreign corporations
Yes

International Activities

RegionActivityServicesOfficesEmployeesSpending
Central America and the Caribbean -Investments reported on cost basis-00$84,314,422
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$691,652
Fundraising Direct Expenses$348,525
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Race Against Breast Cancer$526,796$186,019-$186,019
The Big Grape Reserve$243,850$38,862-$38,862
Total Events$1,861,845$691,652$348,525$343,127
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

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

Bond Issues

BondIssuerIssuedIssue PricePurpose
ASouth Dakota Health and Educational Facilities Authority2012-05-01$206,383,9272012A funded a project and refunded Series 2008A and Series 2002
ASouth Dakota Health and Educational Facilities Authority2008-06-18$189,222,9322008B refund bonds issued 1/12/1995 and 3/01/2000 and capital expenditures
CSouth Dakota Health and Educational Facilities Authority2008-06-18$189,222,9322012B refunded Series 1994, 2000, and bridge loan
DSouth Dakota Health and Educational Facilities Authority2014-06-26$61,821,6882014A Various capital projects
BSouth Dakota Health and Educational Facilities Authority2008-07-01$61,495,0002008C refunded 2006 Series

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
A$206,383,927$167,251,505$142,153,927$1,032,422
A$189,222,932--$1,272,562
C$189,222,932$96,658,796$68,487,932$1,272,562
D$61,821,688$37,818,499-$821,688
B$61,495,000$61,075,000$5,745,000$388,831

Bond Financing Compliance

No rebate due
Yes
Rebate not yet due
No
Form 8038-T filed
No
Gross proceeds invested
No
Gross proceeds invested in GIC
No
Exception to rebate
No
Corrective action procedures
Yes
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, line 6

The organization has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of six Sisters- three Presentation Sisters appointed by the Presentation Sponsorship Members and three Benedictine Sisters appointed by the Benedictine Sponsorship Members.

Form 990, Part VI, Section A, line 7A

The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health.

Form 990, Part VI, Section A, line 7B

The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the President and Chief Executive Officer; (e) To review and approve the operating and capital budgets, including expenditures outside of budget, and the strategic plan, of Avera Health; (f) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (g) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (h) To adopt policies designed to effectuate the powers reserved to the System Members; and (i) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members.

Form 990, Part VI, Section A, line 8B

Avera Health does not have any committees with authority to act on behalf of the governing body.

Form 990, Part VI, Section B, line 11B

The Form 990 is reviewed by the CEO and CFO. After initial reviews, the return is provided to the board prior to filing.

Form 990, Part VI, Section B, line 12C

The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board.

Form 990, Part VI, Section B, line 15

Annually the Compensation Committee of Avera Health, which is comprised of six (6) system members appointed by the religious orders, meets with an independent consultant regarding fair market value for compensation of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.

Form 990, Part VI, Section C, line 19

The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public.

Form 990, Part VI Question 16B:

There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.

Filing and Contact Details

Filer

Filer Name
Avera Health
EIN
46-0422673
Phone
6053227300
Address
3900 WEST AVERA DRIVE No 300, SIOUX FALLS, SD 57108

Signing Officer

Name
Jim Breckenridge
Title
Secretary/Treasurer
Phone
6053224700
Signed
2018-05-10
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John Porter
Formed
1998
Legal Domicile
Sd
Voting Board Members
14
Independent Board Members
12
Employees
1,381
Volunteers
35

Preparer

Firm
Eide Bailly LLP
Address
800 Nicollet Mall Ste 1300, Minneapolis, MN 55402-7033
Preparer
Kim Hunwardsen
Phone
6122536500
Supplemental Narrative

Additional Explanations

Form 990, Part IX, line 11G

Purchased services: Program service expenses 335,452. Management and general expenses 6,308. Fundraising expenses 0. Total expenses 341,760. Contracted services: Program service expenses 26,315,497. Management and general expenses 5,477,688. Fundraising expenses 0. Total expenses 31,793,185. Repairs and maintenance: Program service expenses 1,335,210. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,335,210. Professional fees: Program service expenses 16,393. Management and general expenses 159,219. Fundraising expenses 0. Total expenses 175,612. Recruitment: Program service expenses 363,394. Management and general expenses 0. Fundraising expenses 0. Total expenses 363,394.

Form 990, Part X, Line 20:

Avera Health is only disclosing a portion of the tax exempt bonds on Part X, Line 20. The bonds were issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, and Avera Sacred Heart. In accordance with IRS Instructions, information related to the entire tax exempt bond reporting is being reported on Avera Health's tax return on Schedule K.

Form 990, Part XI, line 9:

Net equity transfers 12,514,356. Insurance program admin income not recognized for tax reporting 13,026,668. Change in interest in net assets of foundations and trusts -61,649. Contributions received by Foundation - not reflected in financial statement -10,658,556. Net assets released from restrictions -1,011,260.

Financial Statement Notes

Part IV, Line 2B:

Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements.

Part V, Line 4:

The Organization's endowment consists of approximately 98 individual funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations.

Part X, Line 2:

Avera Health and most of its sponsored organizations are considered nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. These organizations are required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). Avera Health and certain sponsored organizations also file an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report their unrelated business taxable income. Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The federal Form 990T filings and taxable subsidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2014.

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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt120
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt130
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt140
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt150
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt160
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt170
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt180
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt190
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt200
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt210
IRS990/Form990PartVIISectionAGrp/TitleTxt0Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt1Vice Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt2Director
IRS990/Form990PartVIISectionAGrp/TitleTxt3Director
IRS990/Form990PartVIISectionAGrp/TitleTxt4Director
IRS990/Form990PartVIISectionAGrp/TitleTxt5Director
IRS990/Form990PartVIISectionAGrp/TitleTxt6Director
IRS990/Form990PartVIISectionAGrp/TitleTxt7Director
IRS990/Form990PartVIISectionAGrp/TitleTxt8Director
IRS990/Form990PartVIISectionAGrp/TitleTxt9Director
IRS990/Form990PartVIISectionAGrp/TitleTxt10Director
IRS990/Form990PartVIISectionAGrp/TitleTxt11Director
IRS990/Form990PartVIISectionAGrp/TitleTxt12Director
IRS990/Form990PartVIISectionAGrp/TitleTxt13President & CEO
IRS990/Form990PartVIISectionAGrp/TitleTxt14Sec/Treas & SrVP Finance
IRS990/Form990PartVIISectionAGrp/TitleTxt15Chief Operating Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt16Chief Administrative Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt17Sr VP Medical Affairs
IRS990/Form990PartVIISectionAGrp/TitleTxt18Pres/CEO-St. Luke's
IRS990/Form990PartVIISectionAGrp/TitleTxt19Senior VP - General Counsel
IRS990/Form990PartVIISectionAGrp/TitleTxt20Pres/CEO-McKennan
IRS990/Form990PartVIISectionAGrp/TitleTxt21Senior VP - CIO
IRS990/Form990ProvidedToGvrnBodyInd01
IRS990/Form990TFiledInd01
IRS990/FormationYr01998
IRS990/FormerOfcrEmployeesListedInd00
IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd0X
IRS990/FSAuditedInd01
IRS990/FundraisingActivitiesInd01
IRS990/FundraisingAmt01170193
IRS990/FundraisingDirectExpensesAmt0348525
IRS990/FundraisingGrossIncomeAmt0691652
IRS990/GainOrLossGrp/OtherAmt015123
IRS990/GainOrLossGrp/SecuritiesAmt012820074
IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt014
IRS990/GovernmentGrantsAmt04551896
IRS990/GrantAmt05790679
IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt0139545
IRS990/GrantsToDomesticIndividualsGrp/TotalAmt0139545
IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt05651134
IRS990/GrantsToDomesticOrgsGrp/TotalAmt05651134
IRS990/GrantsToIndividualsInd01
IRS990/GrantsToOrganizationsInd01
IRS990/GrantToRelatedPersonInd00
IRS990/GrossAmountSalesAssetsGrp/OtherAmt015123
IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt013296966
IRS990/GrossReceiptsAmt0221045858
IRS990/GrossRentsGrp/RealAmt01433849
IRS990/GroupExemptionNum00928
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd01
IRS990/IndependentAuditFinclStmtInd00
IRS990/IndependentVotingMemberCnt012
IRS990/IndivRcvdGreaterThan100KCnt0145
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartIIIInd0X
IRS990/InfoInScheduleOPartIXInd0X
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InfoInScheduleOPartXIInd0X
IRS990/InfoInScheduleOPartXInd0X
IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt015132
IRS990/InformationTechnologyGrp/ProgramServicesAmt05114222
IRS990/InformationTechnologyGrp/TotalAmt05129354
IRS990/InsuranceGrp/ManagementAndGeneralAmt096822
IRS990/InsuranceGrp/ProgramServicesAmt0117310
IRS990/InsuranceGrp/TotalAmt0214132
IRS990/IntangibleAssetsGrp/BOYAmt016139552
IRS990/IntangibleAssetsGrp/EOYAmt016139552
IRS990/InterestGrp/ManagementAndGeneralAmt0781202
IRS990/InterestGrp/TotalAmt0781202
IRS990/InventoriesForSaleOrUseGrp/BOYAmt0180711
IRS990/InventoriesForSaleOrUseGrp/EOYAmt0962367
IRS990/InvestmentIncomeGrp/ExclusionAmt02768304
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt02768304
IRS990/InvestmentInJointVentureInd01
IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt0137216010
IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt0156100597
IRS990/InvestmentsProgramRelatedGrp/BOYAmt043432
IRS990/InvestmentsProgramRelatedGrp/EOYAmt033615
IRS990/InvestmentsPubTradedSecGrp/BOYAmt0678919195
IRS990/InvestmentsPubTradedSecGrp/EOYAmt0755017402
IRS990/InvestTaxExemptBondsInd00
IRS990/IRPDocumentCnt0268
IRS990/IRPDocumentW2GCnt00
IRS990/LandBldgEquipAccumDeprecAmt060192389
IRS990/LandBldgEquipBasisNetGrp/BOYAmt096593254
IRS990/LandBldgEquipBasisNetGrp/EOYAmt0102696792
IRS990/LandBldgEquipCostOrOtherBssAmt0162889181
IRS990/LegalDomicileStateCd0SD
IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt00
IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt0476892
IRS990/LessRentalExpensesGrp/RealAmt01326701
IRS990/LoanOutstandingInd00
IRS990/LobbyingActivitiesInd01
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembersOrStockholdersInd01
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd00
IRS990/MinutesOfGoverningBodyInd01
IRS990/MissionDesc0Avera Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.
IRS990/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt083517570
IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt030823538
IRS990/NetAssetsOrFundBalancesBOYAmt0273584861
IRS990/NetAssetsOrFundBalancesEOYAmt0312158082
IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt012835197
IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt012835197
IRS990/NetIncmFromFundraisingEvtGrp/ExclusionAmt0343127
IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt0343127
IRS990/NetRentalIncomeOrLossGrp/TotalRevenueColumnAmt0107148
IRS990/NetRentalIncomeOrLossGrp/UnrelatedBusinessRevenueAmt0107148
IRS990/NetUnrelatedBusTxblIncmAmt0-179911

Document Assets

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Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$2,306$1,969$338$278$280$1.96
2023Detailed filing. Detailed filing data is available for this year.$1,738$1,436$302$285$292$6.54
2022Detailed filing. Detailed filing data is available for this year.$1,757$1,298$458$442$292$149
2021Detailed filing. Detailed filing data is available for this year.$1,762$1,374$388$324$333$9.57
2020Detailed filing. Detailed filing data is available for this year.$1,513$1,166$347$296$267$28.9
2019Detailed filing. Detailed filing data is available for this year.$1,324$1,014$310$274$271$3.05
2018Detailed filing. Detailed filing data is available for this year.$1,282$979$303$225$235$9.44
2017Detailed filing. Detailed filing data is available for this year.$1,067$755$312$219$196$23.2
2016Detailed filing. Detailed filing data is available for this year.$1,318$1,044$274$191$171$20.0
2015Detailed filing. Detailed filing data is available for this year.$1,373$1,112$261$169$150$19.3
2014Detailed filing. Detailed filing data is available for this year.$1,372$1,121$251$135$119$15.4
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,156$945$211$87.6
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,060$895$166$74.1
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$700$523$177$63.3
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$570$442$128$42.9