Civic Intelligence

Avera Health

990 • Fiscal year 2018 • EIN 46-0422673

Jul 01, 2017 to Jun 30, 2018 • Filed on May 13, 2019

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

89th percentile

0.76x

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

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Liabilities / Revenue

91st percentile

4.34x

Higher debt load relative to revenue than 91% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Net Margin

8th percentile

-4.2%

Higher net margin than 8% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Top Officer Pay

51st percentile

$1,806,536

Higher top officer pay than 51% of similar nonprofits.

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

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Asset Growth

91st percentile

20%

Faster asset growth than 91% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Revenue Growth

29th percentile

3.0%

Faster revenue growth than 29% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Assets

Up

$1,282,022,027

Up $214,585,307 (+20%) from 2017

Net Assets

Down

$303,354,067

Down $8,804,015 (-2.8%) from 2017

Liabilities

Up

$978,667,960

Up $223,389,322 (+30%) from 2017

Revenue

Up

$225,457,103

Up $6,563,363 (+3.0%) from 2017

Expenses

Up

$234,897,798

Up $39,181,997 (+20%) from 2017

Net Income

Down

-$9,440,695

Down $32,618,634 (-141%) from 2017

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

2018

Assets$1,282,022,027
Liabilities$978,667,960
Net Assets$303,354,067

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

2018

Revenue$225,457,103
Expenses$234,897,798
Net Income-$9,440,695
Jump To
Filing Snapshot
Filing Period
Jul 1, 2017 to Jun 30, 2018
Signed
May 13, 2019
Return Version
2017v2.3
Gross Receipts
$227,619,779
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$755,017,402$796,174,085▲ $41,156,683
Investments Other Securities$156,100,597$180,652,447▲ $24,551,850
Land, Buildings, and Equipment, Net$102,696,792$98,521,120▼ $4,175,672
Savings and Temporary Cash Investments$2,587,101$22,583,709▲ $19,996,608
Intangible Assets$16,139,552$16,139,552→ $0
Accounts Receivable$11,520,461$15,166,840▲ $3,646,379
Prepaid Expenses and Deferred Charges$7,678,449$10,269,822▲ $2,591,373
Other Notes and Loans Receivable, Net$4,750,610$4,652,651▼ $97,959
Inventories for Sale or Use$962,367$511,303▼ $451,064
Pledges and Grants Receivable$819,321$230,615▼ $588,706
Investments Program Related$33,615$21,208▼ $12,407
Total Assets$1,067,436,720$1,282,022,027▲ $214,585,307
Other Assets Total$9,130,453$137,098,675▲ $127,968,222
Liabilities
Escrow Account Liability$645,715,791$708,539,428▲ $62,823,637
Other Liabilities$41,595,037$177,427,247▲ $135,832,210
Accounts Payable and Accrued Expenses$20,592,416$31,744,090▲ $11,151,674
Mortgage Notes Payable Secured by Investment Property$30,823,538$29,145,378▼ $1,678,160
Tax Exempt Bond Liabilities$10,473,243$28,066,451▲ $17,593,208
Deferred Revenue$6,078,613$3,745,366▼ $2,333,247
Total Liabilities$755,278,638$978,667,960▲ $223,389,322
Net Assets / Fund Balance
Unrestricted Net Assets$308,992,474$300,038,875▼ $8,953,599
Temporarily Rstr Net Assets$2,720,423$2,824,509▲ $104,086
Permanently Rstr Net Assets$445,185$490,683▲ $45,498
Total Net Assets Fund Balance$312,158,082$303,354,067▼ $8,804,015
Total Liabilities and Net Assets / Fund Balance$1,067,436,720$1,282,022,027▲ $214,585,307

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$54,049,632$68,933,566$122,983,198
Buildings$21,234,628$8,510,237$29,744,865
Other Land Buildings$20,201,096-$20,201,096
Leasehold Improvements$2,087,164$2,467,172$4,554,336
Land$948,600-$948,600
Other Assets Org$500--
Other Securities$600,286--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2017$5,004,011$421,937▲ $280,361$386,932$5,295,563
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
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
John PorterPresident and CEO thru May 2018FT$1,282,547$523,989$1,806,536
Fredrick SluneckaChief Operating OfficerFT$1,097,138$106,406$1,203,544
David Kapaska - Former HCEPres/CEO - Avera McKennan-$374,121$633,307$1,007,428
James BreckenridgeSecretary and CFOFT$815,781$105,741$921,522
David EricksonChief Medical OfficerFT$557,540$246,603$804,143
David FlicekPres/CEO - Avera McKennanFT$689,489$96,429$785,918
Todd ForkelPres/CEO - Avera St. Luke's-$512,786$202,899$715,685
Richard KormanSenior VP - General CounselFT$570,831$97,281$668,112
Robin BatesExec VP - Ins Serv and Pop HealthFT$506,105$84,540$590,645
Bob SuttonPresident and CEO began June 2018FT$392,340$173,077$565,417
Douglas EkerenPres/CEO - Avera Sacred Heart-$376,003$164,432$540,435

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$9,684,315
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
$14,467,701
Program Service Revenue
$199,967,555
Investment Income
$2,304,385
Other Revenue
$8,717,462
All Other Contributions
$10,788,697
Change in Net Assets
$-9,440,695

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 Traded8$119,655Avg of high/low
Other Non Cash Contri Table1$75,000cost
Other Non Cash Contri Table21$31,666cost
Other Non Cash Contri Table1$20,515cost
Other Non Cash Contri Table1$4,829cost
Total Noncash Contributions32$251,665-
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$121,091,438
Other Expenses$98,223,646
Grants and Similar Amounts Paid$15,582,714
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$77,316,335$10,431,838-$87,748,173
Fees for Services Other$37,023,388$5,138,971-$42,162,359
Depreciation Depletion$19,030,129$688,456-$19,718,585
Grants to Domestic Orgs$15,422,839--$15,422,839
Other Employee Benefits$12,960,815$2,308,524-$15,269,339
Information Technology$9,398,966$98,067-$9,497,033
Advertising$9,238,883$75,875-$9,314,758
Office Expenses$7,350,691$423,694-$7,774,385
Pension Plan Contributions$6,791,268$871,722-$7,662,990
Payroll Taxes$6,005,256$465,789-$6,471,045
Current Officers, Directors, Trustees, and Key Employees-$3,880,365-$3,880,365
Occupancy$3,259,112$615,761-$3,874,873
Travel$1,756,295$176,674-$1,932,969
Conferences and Meetings$1,053,376$150,565-$1,203,941
Fees for Services Accounting$763,699$415,319-$1,179,018
Insurance$232,869$120,367-$353,236
Other Expenses$340,126$486,511-$340,126
Interest-$255,078-$255,078
Grants to Domestic Individuals$159,875--$159,875
Fees for Services Legal-$106,657-$106,657
Comp Disqual Persons$59,526--$59,526
Fees for Services Lobbying$40,956--$40,956
All Other Expenses$606,792$-1,727,277-$-1,120,485
Total Functional Expenses$209,907,828$24,989,970$0$234,897,798
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Avera McKennan HospitalSioux Falls, SD501c3Sponsorship$4,180,006
Sioux Falls Catholic SchoolsSioux Falls, SD501c6Sponsorship$1,000,000
Eureka Community Health ServicesEureka, SD501c3Sponsorship$833,813
Avera Queen of Peace HospitalMitchell, SD501c3Sponsorship$528,928
University of Sioux FallsSioux Falls, SD501c3Sponsorship$400,000
Mount Marty CollegeYankton, SD501c3Sponsorship$258,081
Floyd Valley HealthcareLemars, IA501c3Sponsorship$255,289
Presentation CollegeAberdeen, SD501c3Sponsorship$250,600
Avera Holy FamilyEstherville, IA501c3Sponsorship$238,253
Avera at HomeSioux Falls, SD501c3Sponsorship$166,525
SDSU FoundationBrookings, SD501c3Scholarship$165,000
Forward Sioux FallsSioux Falls, SDState of SDSponsorship$150,000
NSU FoundationAberdeen, SD501c6Sponsorship$150,000
Avera St Mary'sPierre, SD501c3Sponsorship$129,164
Catholic Community Foundation for Eastern SDSioux Falls, SD501c3Sponsorship$100,000
Aberdeen Catholic School SystemAberdeen, SD501c3Sponsorship$89,500
Sioux Empire United WaySioux Falls, SD501c3Sponsorship$84,240
Avera MarshallMarshall, MN501c3Sponsorship$80,720
Mitchell Technical Institute FoundationMitchell, SD501c3Sponsorship$80,250
Landmann-Jungman Memorial HospitalScotland, SD501c3Sponsorship$78,964
USD FoundationVermillion, SD501c3Scholarship$75,000
Weskota Manor IncWessington Springs, SD-Sponsorship$68,787
Boys & Girls Club of Aberdeen AreaAberdeen, SD501c3Sponsorship$60,000
Yankton Area Progressive GrowthYankton, SD501c3Sponsorship$60,000
South Dakota Symphony OrchestraSioux Falls, SD501c3Sponsorship$57,250
Avera St Luke'sAberdeen, SD501c3Sponsorship$51,449
Holy Redeemer Catholic ChurchMarshall, MN501c3Sponsorship$50,000
South Dakota Community FoundationPierre, SD501c3Sponsorship$50,000
Stockyards Plaza IncSioux Falls, SD501c3Sponsorship$50,000
Sacred Heart Health ServicesYankton, SD501c3Sponsorship$42,131
Platte Health CenterPlatte, SD-Sponsorship$39,865
Children's Museum of South DakotaBrookings, SD501c3Sponsorship$38,657
American Cancer SocietyAtlanta, GA501c3Sponsorship$37,900
Brookings School DistrictBrookings, SDCity of BrookingsSponsorship$36,050
Catholic Charities USAAlexandria, VA501c3Sponsorship$35,588
Dakota ResourcesRenner, SD501c3Sponsorship$35,000
Hegg Memorial Health CenterRock Valley, IA501c3Sponsorship$34,620
Dakota Wesleyan UniversityMitchell, SD501c3Sponsorship$34,500
Marshall County Healthcare CenterBritton, SD501c3Sponsorship$33,495
EmBeSioux Falls, SD501c3Sponsorship$31,500
Brookings Health SystemBrookings, SDCity of BrookingsSponsorship$30,500
American Red CrossWashington, DC501c3Sponsorship$28,088
NAMI South DakotaSioux Falls, SD501c3Sponsorship$27,500
Harrisburg School DistrictHarrisburg, SD501c3Sponsorship$27,000
USD Sanford School of MedicineVermillion, SD501c6Sponsorship$25,250
Feeding South DakotaSioux Falls, SD501c3Sponsorship$25,100
American Heart Association - Midwest AffiliatePrescott, AZ501c3Sponsorship$25,000
Dow Rummel VillageSioux Falls, SD501c4Sponsorship$25,000
Mitchell Aquatic ClubMitchell, SD501c3Sponsorship$25,000
National Field Archery Association FoundationYankton, SD501c3Sponsorship$25,000
South Dakota Hall of FameChamberlain, SD501c3Sponsorship$25,000
Lakes Regional HealthcareSpirit Lake, IA501c3Sponsorship$24,782
Avera GettysburgGettysburg, SD501c3Sponsorship$23,000
Presentation Sisters of the Blessed Virgin MaryAberdeen, SD501c3Sponsorship$22,500
Downtown Sioux Falls IncSioux Falls, SD501c3Sponsorship$21,000
Delta Dental of South Dakota FoundationPierre, SD501c3Sponsorship$20,000
Fellowship of Christian AthletesKansas City, MO501c3Sponsorship$20,000
Philanthropy Promotions IncSioux Falls, SD501c3Sponsorship$20,000
Ronald McDonald House Charities of SDSioux Falls, SD501c3Sponsorship$20,000
Sioux Falls Jazz & Blues SocietySioux Falls, SD501c3Sponsorship$20,000
Southeast Technical Institute FoundationSioux Falls, SD501c3Scholarship$20,000
Vision Brookings FoundationBrookings, SDCity of YanktonSponsorship$20,000
SculptureWalk IncSioux Falls, SD501c3Sponsorship$19,500
Etc for HerSioux Falls, SD501c3Sponsorship$19,000
Family Visitation CenterSioux Falls, SD501c3Sponsorship$18,500
Harrisburg Baseball AssociationHarrisburg, SD501c3Sponsorship$18,000
Sioux Falls Youth Hockey AssociationSioux Falls, SD501c3Sponsorship$17,500
Special Olympics South DakotaSioux Falls, SD501c3Sponsorship$17,500
Junior Achievement of South DakotaSioux Falls, SD501c4Sponsorship$17,025
Governor's Office of Economic DevelopmentPierre, SD501c3Sponsorship$16,000
Sioux Empire Baseball AssociationSioux Falls, SD501c3Sponsorship$16,000
The National MS Society Upper Midwest ChapterMinneapolis, MN501c3Sponsorship$16,000
National Kidney FoundationNew York, NYState of SDSponsorship$15,500
ALS Association - MNNDSD ChapterMinneapolis, MN501c3Sponsorship$15,000
Aberdeen Ride LineAberdeen, SD501c3Sponsorship$15,000
City of MitchellMitchell, SDCity of MitchellSponsorship$15,000
Destiny Healthcare InternationalSioux Falls, SD501c3Sponsorship$15,000
Habitat for Humanity of the Brookings AreaBrookings, SD501c3Sponsorship$15,000
Helpline Center IncSioux Falls, SD501c3Sponsorship$15,000
Volunteers of America DakotasSioux Falls, SD501c3Sponsorship$15,000
Yankton School District 63-3Yankton, SD501c3Sponsorship$15,000
Pipestone County Medical CenterPipestone, MN-Sponsorship$14,625
DakotAbilitiesSioux Falls, SD501c3Sponsorship$13,000
Sioux Falls School District 49-5 (CTE Academy)Sioux Falls, SDCity of Sioux FallsSponsorship$12,500
Teach for America-South DakotaNew York, NY501c3Sponsorship$12,500
United Way of YanktonYankton, SDState of SDSponsorship$12,500
Children's Home Society of South Dakota FoundationSioux Falls, SD501c3Sponsorship$12,000
St Benedict Health CenterParkston, SD501c3Sponsorship$11,458
Daktronics IncMinneapolis, MN501c3Community Development$11,250
McCrossan Boys RanchSioux Falls, SD501c3Sponsorship$11,000
Safe HarborAberdeen, SD501c3Sponsorship$11,000
Aberdeen Christian SchoolAberdeen, SD501c3Sponsorship$10,500
American Red Cross of Eastern SDSioux Falls, SD501c3Sponsorship$10,000
Bishop Dudley Hospitality HouseSioux Falls, SD501c3Sponsorship$10,000
Boys & Girls Club of the Sioux EmpireSioux Falls, SD501c3Sponsorship$10,000
Brandon Valley Baseball AssociationBrandon, SD501c3Sponsorship$10,000
Canton School District 41-1Canton, SDCity of CantonSponsorship$10,000
Citizens Involvement CouncilPierre, SD501c3Sponsorship$10,000
Glacial Lakes Area DevelopmentBritton, SD501c3Sponsorship$10,000
LifeLight Communications IncSioux Falls, SD501c3Sponsorship$10,000
Make-A-Wish Foundation of SDSioux Falls, SD501c3Sponsorship$10,000
Pierre School DistrictPierre, SD501c3Sponsorship$10,000
Post 8 BaseballPierre, SD501c3Sponsorship$10,000
Pride in the Tiger FoundationMarshall, MN501c3Sponsorship$10,000
SD Youth Foundation IncBrookings, SD501c3Sponsorship$10,000
South Dakot Agriculatural & Rural Leadership IncRapid City, SD501c3Sponsorship$10,000
United Way of Northeastern SD IncAberdeen, SD501c3Sponsorship$10,000
Avera TylerTyler, MN501c3Sponsorship$9,981
Friends for Health in HaitiPewaukee, WI501c3Sponsorship$9,450
Furniture Mission of South DakotaSioux Falls, SD501c3Sponsorship$9,000
American Cancer Society Cancer Action NetworkWashington, DC501c4Sponsorship$8,500
South Dakota State UniversityBrookings, SD501c3Sponsorship$8,010
Weskota FoundationWessington Springs, SD501c3Sponsorship$7,569
King of Glory ChurchSioux Falls, SD501c3Sponsorship$7,500
Marshall Fire Department Relief AssnMarshall, MN501c3Sponsorship$7,500
OLLI at University CenterSioux Falls, SDCity of PierreSponsorship$7,500
South Dakota Chamber of Commerce and IndustryPierre, SD501c3Sponsorship$7,500
Charis Ministry PartnersSioux Falls, SD501c3Sponsorship$7,000
Tempo Soccer ClubTea, SD501c3Sponsorship$7,000
Pierre Area Chamber of CommercePierre, SDState of SDSponsorship$6,700
Brandon Valley Booster ClubBrandon, SD501c3Sponsorship$6,500
Ground WorksSioux Falls, SDCity of HarrisburgSponsorship$6,000
Mitchell United WayMitchell, SD501c3Sponsorship$6,000
Compass CenterSioux Falls, SD501c3Sponsorship$5,500
Prairie Family Business AssociationSioux Falls, SD501c3Sponsorship$5,500

International Summary

Offices
0
Employees
0
Spending
$106,809,297

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$106,809,297
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$683,749
Fundraising Direct Expenses$374,291
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Race Against Breast Cancer$500,173$171,872$139,638$32,234
The Big Grape Reserve$215,836$41,886$43,840$-1,954
Total Events$1,763,126$683,749$374,291$309,458
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
-Owned by board memberOffice product purchasesNo$3,397,145
Grant FlicekFamily member of David Flicek, key employeeCompensation as an employeeNo$59,526
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to affiliated entities$131,724,780
Estimated insurance claims payable$37,157,888
Bond interest payable$8,544,579

Bond Issues

BondIssuerIssuedIssue PricePurpose
ASouth Dakota Health and Educational Facilities Authority2017-10-11$242,848,916Series 2017 refund bond issued 6/18/08;construct/equip healthcare facilities
ASouth Dakota Health and Educational Facilities Authority2012-05-01$206,383,9272012A funded a project and refunded Series 2008A and Series 2002
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$242,848,916--$1,786,422
A$206,383,927$167,251,505$144,093,927$1,032,422
C$189,222,932$96,658,796$71,102,932$1,272,562
D$61,821,688$51,062,494$3,071,688$821,688
B$61,495,000$61,075,000$7,520,000$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
Yes
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 VP of Financial Reporting, Tax Manager, and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders.

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, Section B, Line 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.

Form 990, Part VII:

David Flicek served as Chief Administration Officer for Avera Health through calendar year 2017. Starting in calendar year 2018 he served as President/CEO for Avera McKennan, a related organization. Part VII shows 40 hours served for Avera Health, the reporting organization, and 40 hours served for Avera McKennan, a related organization.

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 and CFO
Phone
6053224700
Signed
2019-05-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Bob Sutton
Formed
1998
Legal Domicile
Sd
Voting Board Members
14
Independent Board Members
11
Employees
1,381
Volunteers
39

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 585,713. Management and general expenses 9,317. Fundraising expenses 0. Total expenses 595,030. Contracted services: Program service expenses 34,710,645. Management and general expenses 5,097,505. Fundraising expenses 0. Total expenses 39,808,150. Repairs and maintenance: Program service expenses 1,216,231. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,216,231. Professional fees: Program service expenses 170,435. Management and general expenses 15,251. Fundraising expenses 0. Total expenses 185,686. Recruitment: Program service expenses 340,364. Management and general expenses 16,898. Fundraising expenses 0. Total expenses 357,262.

Form 990, Part X, Line 20:

The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Gettysburg and Avera at Home. 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 XI, line 9:

Net equity transfers -2,065,416. Insurance program admin income not recognized for tax reporting -826,050. Change in interest in net assets of foundations and trusts 47,507. Contributions received by Avera Health Foundation not reflected in financial statements -11,836,392. Net assets released from restrictions -528,894. Grants to organizations distributed by Avera Health Foundation not reflected in financial statements 11,127,814.

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 Internal Revenue 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 consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The 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 2015. Certain consolidated entities are subject to federal income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. Deferred tax assets and liabilities are not material as of June 30, 2018 and 2017. The Organization paid an immaterial amount of federal and state income taxes for the years ended June 30, 2018 and 2017.

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IRS990/Form990PartVIISectionAGrp/PersonNm13Sister Pam Donelan
IRS990/Form990PartVIISectionAGrp/PersonNm14John Porter
IRS990/Form990PartVIISectionAGrp/PersonNm15Bob Sutton
IRS990/Form990PartVIISectionAGrp/PersonNm16James Breckenridge
IRS990/Form990PartVIISectionAGrp/PersonNm17Fredrick Slunecka
IRS990/Form990PartVIISectionAGrp/PersonNm18David Flicek
IRS990/Form990PartVIISectionAGrp/PersonNm19David Erickson
IRS990/Form990PartVIISectionAGrp/PersonNm20Todd Forkel
IRS990/Form990PartVIISectionAGrp/PersonNm21Richard Korman
IRS990/Form990PartVIISectionAGrp/PersonNm22Robin Bates
IRS990/Form990PartVIISectionAGrp/PersonNm23Douglas Ekeren
IRS990/Form990PartVIISectionAGrp/PersonNm24David Kapaska - Former HCE
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt50
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt60
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt70
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt80
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt90
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt100
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt110
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt120
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt130
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt141768380
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt15522924
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt16887406
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt171167988
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt18742425
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt19761544
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt20683117
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt21625619
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt22552489
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt23502279
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt24983620
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt60
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt7203313
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt80
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt90
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt100
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt110
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/ReportableCompFromRltdOrgAmt220
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt230
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt240
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/TitleTxt13Director
IRS990/Form990PartVIISectionAGrp/TitleTxt14President and CEO thru May 2018
IRS990/Form990PartVIISectionAGrp/TitleTxt15President and CEO began June 2018
IRS990/Form990PartVIISectionAGrp/TitleTxt16Secretary and CFO
IRS990/Form990PartVIISectionAGrp/TitleTxt17Chief Operating Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt18Pres/CEO - Avera McKennan
IRS990/Form990PartVIISectionAGrp/TitleTxt19Chief Medical Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt20Pres/CEO - Avera St. Luke's
IRS990/Form990PartVIISectionAGrp/TitleTxt21Senior VP - General Counsel
IRS990/Form990PartVIISectionAGrp/TitleTxt22Exec VP - Ins Serv and Pop Health
IRS990/Form990PartVIISectionAGrp/TitleTxt23Pres/CEO - Avera Sacred Heart
IRS990/Form990PartVIISectionAGrp/TitleTxt24Pres/CEO - Avera McKennan
IRS990/Form990ProvidedToGvrnBodyInd01
IRS990/Form990TFiledInd01
IRS990/FormationYr01998
IRS990/FormerOfcrEmployeesListedInd01
IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd0X
IRS990/FSAuditedInd01
IRS990/FundraisingActivitiesInd01
IRS990/FundraisingAmt01079377
IRS990/FundraisingDirectExpensesAmt0374291
IRS990/FundraisingGrossIncomeAmt0683749
IRS990/GainOrLossGrp/OtherAmt018868
IRS990/GainOrLossGrp/SecuritiesAmt0967564
IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt014
IRS990/GovernmentGrantsAmt01888591
IRS990/GrantAmt015582714
IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt0159875
IRS990/GrantsToDomesticIndividualsGrp/TotalAmt0159875
IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt015422839
IRS990/GrantsToDomesticOrgsGrp/TotalAmt015422839
IRS990/GrantsToIndividualsInd01
IRS990/GrantsToOrganizationsInd01
IRS990/GrantToRelatedPersonInd00
IRS990/GrossAmountSalesAssetsGrp/OtherAmt018868
IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt0967564
IRS990/GrossReceiptsAmt0227619779
IRS990/GrossRentsGrp/RealAmt01877516
IRS990/GroupExemptionNum00928
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd01
IRS990/IndependentAuditFinclStmtInd00
IRS990/IndependentVotingMemberCnt011
IRS990/IndivRcvdGreaterThan100KCnt0154
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartIIIInd0X
IRS990/InfoInScheduleOPartIXInd0X
IRS990/InfoInScheduleOPartVIIInd0X
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InfoInScheduleOPartXIInd0X
IRS990/InfoInScheduleOPartXInd0X
IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt098067
IRS990/InformationTechnologyGrp/ProgramServicesAmt09398966
IRS990/InformationTechnologyGrp/TotalAmt09497033
IRS990/InsuranceGrp/ManagementAndGeneralAmt0120367
IRS990/InsuranceGrp/ProgramServicesAmt0232869
IRS990/InsuranceGrp/TotalAmt0353236
IRS990/IntangibleAssetsGrp/BOYAmt016139552
IRS990/IntangibleAssetsGrp/EOYAmt016139552
IRS990/InterestGrp/ManagementAndGeneralAmt0255078
IRS990/InterestGrp/TotalAmt0255078
IRS990/InventoriesForSaleOrUseGrp/BOYAmt0962367
IRS990/InventoriesForSaleOrUseGrp/EOYAmt0511303
IRS990/InvestmentIncomeGrp/ExclusionAmt01317953
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt01317953
IRS990/InvestmentInJointVentureInd01
IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt0156100597
IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt0180652447
IRS990/InvestmentsProgramRelatedGrp/BOYAmt033615
IRS990/InvestmentsProgramRelatedGrp/EOYAmt021208
IRS990/InvestmentsPubTradedSecGrp/BOYAmt0755017402
IRS990/InvestmentsPubTradedSecGrp/EOYAmt0796174085
IRS990/InvestTaxExemptBondsInd00
IRS990/IRPDocumentCnt0303
IRS990/IRPDocumentW2GCnt00

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

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
Peer Organizations

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