TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) STUART LONNING CHAIR	1.00	X	X	0	0	0
(2) SR KATHLEEN A BIERNE VICE CHAIR	1.00	X	X	0	0	0
(3) SR MILDRED BUSCH DIRECTOR	1.00	X		0	0	0
(4) RICHARD WESTRA DIRECTOR	1.00	X		0	0	0
(5) GARY SHARP DIRECTOR	1.00	X		0	0	0
(6) SR JOANN STURZL DIRECTOR	1.00	X		0	0	0
(7) THOMAS LUZIER MD DIRECTOR	1.00	X		0	0	0
(8) MICHAEL EVANS DIRECTOR	1.00	X		0	0	0
(9) TAGE BORN DIRECTOR	1.00	X		834,082	0	36,148
(10) BOB OLSON DIRECTOR	1.00	X		0	0	0
(11) DEB KNECHT DIRECTOR	1.00	X		0	0	0
(12) JUDITH BLEDSOE DIRECTOR	1.00	X		0	0	0
(13) JOSH KRAFT DIRECTOR	1.00	X		0	0	0
(14) SR DENETTE LEIFELD OSB DIRECTOR	1.00	X		0	0	0
(15) STEPHEN PETERS MD DIRECTOR	40.00	X		0	0	0
(16) RON JACOBSON PRESIDENT & CEO	40.00	X	X	0	533,093	26,824
(17) GEOFFREY DURST SEC/TREAS & SRVP FINANCE	40.00		X	193,078	0	24,859

(A) Name and business address	(B) Description of services	(C) Compensation
ABERDEEN EMERGENCY PHYSICIANS 1411 N 4TH ST ABERDEEN,SD57401	ER PHYSICIAN SERVICES	1,495,464
MED TRANS CORPORATION PO BOX 789 WEST PLAINS,MO65775	HELICOPTER SERVICES	1,296,249
KYBURZ CARLSON CONSTRUCTION CO 729 CIRCLE DRIVE ABERDEEN,SD57401	CONSTRUCTION	943,080
JDH CONSTRUCTION PO BOX 1511 ABERDEEN,SD57401	CONSTRUCTION	529,718
BWBR ARCHITECTS 380 ST PETER STREET SUITE 600 ST PAUL,MN551021996	ARCHITECTURAL SERVICES	426,447
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 24

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	425,163	425,163
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	33,863	33,863
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,759,519	1,533,015	226,504
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	72,884,708	62,847,874	9,857,918	178,916
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	3,831,528	3,298,935	523,202	9,391
9	Other employee benefits .......	9,311,397	8,025,405	1,263,145	22,847
10	Payroll taxes ...........	4,392,544	3,777,265	604,526	10,753
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	32,525		32,525
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	12,759,925	6,505,704	6,254,154	67
12	Advertising and promotion ....	660,385	161,271	485,963	13,151
13	Office expenses .......	11,973,422	10,011,492	1,960,432	1,498
14	Information technology ......	18,552	18,552
15	Royalties ..
16	Occupancy ...........	2,052,381	2,038,545	13,836
17	Travel ............	413,735	257,544	153,727	2,464
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	191,959	176,581	15,378
20	Interest ...........	1,512,622	1,512,622
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	7,386,896	7,386,896
23	Insurance ..............	1,446,750	1,434,738	12,012
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	MEDICAL SUPPLIES	11,641,475	11,641,475
b	BAD DEBT	4,591,607	4,490,015	101,592
c	EQUIPMENT LEASE AND REN	2,017,986	1,958,349	59,637
d	LICENSES AND PERMITS	717,035	107,656	609,379
e
f	All other expenses	1,293,728	1,184,162	106,231	3,335
25	Total functional expenses. Add lines 1 through 24f	151,349,705	128,827,122	22,280,161	242,422
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........		1
2	Savings and temporary cash investments .......	11,147,575	2	10,885,608
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	20,337,349	4	22,863,699
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	607,474	5	400,820
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............	1,671,591	7	1,342,888
8	Inventories for sale or use ..............	2,662,771	8	2,406,234
9	Prepaid expenses and deferred charges ............	1,313,375	9	1,272,613
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	193,926,597
b	Less: accumulated depreciation. .....	10b	115,912,542	76,340,261	10c	78,014,055
11	Investments—publicly traded securities ..........	3,392,212	11	3,519,056
12	Investments—other securities. See Part IV, line 11 ......	62,033,678	12	75,227,320
13	Investments—program-related. See Part IV, line 11 ..	601,306	13	314,451
14	Intangible assets .........	2,684,972	14	2,800,251
15	Other assets. See Part IV, line 11 ...........	1,853,960	15	613,561
16	Total assets. Add lines 1 through 15 (must equal line 34)...	184,646,524	16	199,660,556
	17	Accounts payable and accrued expenses .	14,263,808	17	15,582,263
18	Grants payable ..........		18
19	Deferred revenue ..........		19	4,351
20	Tax-exempt bond liabilities ..........	48,393,292	20	47,588,507
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	84,048	21	85,311
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	5,209,029	25	4,185,236
26	Total liabilities. Add lines 17 through 25.....	67,950,177	26	67,445,668
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	114,946,793	27	129,621,895
28	Temporarily restricted net assets .....	1,224,504	28	2,066,816
29	Permanently restricted net assets .....	525,050	29	526,177
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	116,696,347	33	132,214,888
34	Total liabilities and net assets/fund balances .....	184,646,524	34	199,660,556

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization AVERA ST LUKE'S
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization AVERA ST LUKE'S
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
AVERA ST LUKE'S

Employer identification number

46-0224598

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Yes

11,055

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Total. lines 1c through 1i ...................................

11,055

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	525,050	532,742	582,869
b	Contributions ........
c	Investment earnings or losses ...	1,127	-7,692	-50,127
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	526,177	525,050	532,742

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

100.000 %

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	2,014,558	3,196,845		5,211,403
b	Buildings ................		110,494,545	52,510,317	57,984,228
c	Leasehold improvements ............
d	Equipment ................		73,993,442	61,411,958	12,581,484
e	Other .................		4,227,207	1,990,267	2,236,940
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........					78,014,055

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) SURGICAL ASSOCIATES ENDOSCOPY CENTER LLC	502,775	C
(B) ASSETS LIMITED TO USE - AVERA POOLED INVESTMENTS	72,048,238	F
(C) INVESTMENT IN AVERA HEALTH FOUNDATION	2,676,307	F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)	75,227,320

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS		2,870,000
INTEREST RATE SWAP AGREEMENT		1,315,236







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		4,185,236
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	159,844,388
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	151,349,705
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	8,494,683
4	Net unrealized gains (losses) on investments ..........................	4	6,807,517
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	216,341
9	Total adjustments (net). Add lines 4 - 8 .............................	9	7,023,858
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	15,518,541

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	167,672,891
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	6,807,517
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	2,363,478
e	Add lines 2a through 2d .....................			2e	9,170,995
3	Subtract line 2e from line 1.....................			3	158,501,896
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b	1,342,492
c	Add lines 4a and 4b.......................			4c	1,342,492
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	159,844,388

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	151,624,313
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d	283,865
e	Add lines 2a through 2d......................			2e	283,865
3	Subtract line 2e from line 1.....................			3	151,340,448
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b	9,257
c	Add lines 4a and 4b.......................			4c	9,257
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	151,349,705

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
	PART IV, LINE 2B:	THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS RESIDENTS.
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENTS CONSIST OF A PORTION OF THEIR INTEREST IN THE NET ASSETS OF THE AVERA HEALTH FOUNDATION. THE AVERA HEALTH FOUNDATION INCLUDES ENDOWMENT FUNDS WHICH HAVE BEEN ESTABLISHED FOR A VARIETY OF PURPOSES. 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 UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	THE CENTER HAS IMPLEMENTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION TOPIC ASC 740-10. THE CENTER UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY ASC 740-10. FOR THE YEARS ENDED JUNE 30, 2011 AND 2010, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		CAPITAL TRANSFER -473,387. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 243,793. BOOK/TAX ADJUSTMENT ON INVESTMENT IN ENDOSCOPY LLC 512,756. LOSS FOR RETIREMENT OF DEBT -42,706. DECREASE IN NONCONTROLLING INTEREST -24,115.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		LOSS FROM RETIREMENT OF DEBT RECORDED AS REVENUE FOR FINANCIAL STATEMENTS -42,706. SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC INCOME INCLUDED IN CONSOLIDATED F/S 2,674,261. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS RECORDED IN REVENUE FOR F/S 243,793. RECLASS. OF ACCUM. LOSSES ON INTEREST RATE SWAPS RECORDED IN REVENUE FOR F/S -70,867. ELIMINATIONS REPORTED FOR CONSOLIDATED FINANCIAL STATEMENTS -441,003.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		AUXILIARY REVENUE NOT RECORDED FOR FINANCIAL STATEMENT PURPOSES 18,017. INVESTMENT INCOME REPORTED IN FUND BALANCE FOR FINANCIAL STATEMENTS 108. CHANGE IN INVESTMENT IN SAEC LLC REPORTED FOR TAX PURPOSES 474,867. CHANGE IN INTEREST IN FOUNDATION RECORDED IN FUND BALANCE FOR F/S 849,500.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC EXPENSES PART OF CONSOLIDATED F/S 724,868. ELIMINATIONS REPORTED FOR CONSOLIDATED FINANCIAL STATEMENTS -441,003.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		AUXILIARY EXPENSES NOT RECORDED FOR FINANCIAL STATEMENT PURPOSES 9,257.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other 0 %

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	1,307	1,622,118		1,622,118	1.110 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	8,493	7,849,926	7,623,494	226,432	0.150 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....	406	870,214	805,936	64,278	0.040 %
dTotal Charity Care and Means-Tested Government Programs .....	10,206	10,342,258	8,429,430	1,912,828	1.300 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	35,364	468,948	90,093	378,855	0.260 %
f Health professions education (from Worksheet 5) ..	304	210,410	5,090	205,320	0.140 %
g Subsidized health services (from Worksheet 6) ..	13,168	4,067,079	2,176,318	1,890,761	1.290 %
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..		26,920		26,920	0.020 %
jTotal Other Benefits ...	48,836	4,773,357	2,271,501	2,501,856	1.710 %
kTotal. Add lines 7d and 7j. ..	59,042	15,115,615	10,700,931	4,414,684	3.010 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other	533,015	533,015	0.360 %
10	Total	533,015	533,015	0.360 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

2,008,831

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

43,457,262

Enter Medicare allowable costs of care relating to payments on line 5.....

44,143,859

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-686,597

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC	ENDOSCOPY PROCEDURES	51.000 %	49.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	AVERA ST LUKE'S HOSPITAL 305 S STATE STREET ABERDEEN,SD57401	X	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:NOT REQUIRED

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?13
Name and address		Type of Facility (Describe)
1	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
2	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
3	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
4	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
5	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
6	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
7	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
8	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
9	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
10	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
11	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
12	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING
13	AVERA MOTHER JOSEPH MANOR 1002 N JAY STREET ABERDEEN,SD57401	NURSING HOME, ASSISTED AND CONGREGATE LIVING

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		PART I, LINE 3C: TO DETERMINE ELIGIBILITY FOR CHARITY CARE, AVERA ST. LUKE'S 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 FORM 0 - 100% DEPENDING ON SCORE.
		PART I, LINE 6A: OUR COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY AVERA HEALTH, A RELATED ORGANIZATION. IT IS AVAILABLE THROUGH THE WEBSITE AND REQUESTED MAILING, AND IS FILED WITH THE CATHOLIC HEALTH ASSOCIATION.
		PART I, LINE 7: A COMBINATION OF COSTING METHODOLOGY WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE CHARITY CARE AT COST, UNREIMBURSED MEDICAID AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES. SUBSIDIZED HEALTH WAS CALCULATED BASED ON ACTUAL COST/LOSS. FOR ALL OTHER AMOUNTS, COSTS AND REVENUES AS REFLECTED BY THE GENERAL LEDGER SYSTEM WERE USED.
		PART I, LINE 7G: RURAL HEALTH CLINIC EXPENSES OF $2,112,011 ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES.
		PART I, L7 COL(F): BAD DEBT EXPENSE OF $4,591,607 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
		PART II: OTHER COMMUNITY BUILDING ACTIVITIES REPORTED ON LINE 9 INCLUDE MONETARY AND IN-KIND DONATIONS TO COMMUNITY ORGANIZATIONS TO SUPPORT THE NEEDS OF THE COMMUNITY BEYOND HEALTHCARE. THESE CONTRIBUTIONS STRENGTHEN THE COMMUNITY BY FOCUSING ON UNDERLYING CAUSES OF HEALTH CARE ISSUES.
		PART III, LINE 4: COSTING METHODOLOGY USED TO REPORT BAD DEBT EXPENSE (AT COST) WAS A COST TO CHARGE RATIO AS OUTLINED IN WORKSHEET 2 RATIO OF PATIENT CARE COSTS TO CHARGES.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. UNPAID PATIENT AND RESIDENT RECEIVABLES, EXCLUDING AMOUNTS DUE FROM THIRD-PARTY PAYORS, WITH INVOICE DATES OVER 90 DAYS OLD FOR PATIENT RECEIVABLES AND 60 DAYS OLD FOR RESIDENT RECEIVABLES, HAVE INTEREST ASSESSED AT 1.5 PERCENT PER MONTH.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, LINES 5, 6, AND 7: THE MEDICARE REVENUES RECEIVED (LINE 5), ALLOWABLE COSTS (LINE 6), AND THE RESULTING SHORTFALL (LINE 7) DOES NOT INCLUDE A SIGNIFICANT PORTION OF THE ORGANIZATION'S EXPENSES. THESE LINES REQUIRE USE OF THE MEDICARE COST REPORT AS PREPARED BY THE REQUIRED GUIDELINES WHICH DISALLOWS NUMEROUS COSTS OF HOSPITALS, PARTICULARLY IF THEY ARE PART OF AN INTEGRATED SYSTEM SUCH AS AVERA ST. LUKE'S. THE ENTITY MUST FILE A HOME OFFICE COST REPORT WHICH "STEPS DOWN" OVERHEAD TO NON-COST REPORT ENTITIES DISPROPORTIONATELY TO ACTUAL ALLOWABLE SHARE AND ESSENTIALLY REMOVING THE COSTS FROM THE HOSPITAL'S COST REPORT ENTIRELY. EXAMPLES OF NON-COST REPORT ENTITIES OPERATED BY AVERA ST. LUKE'S INCLUDE CLINICS, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES. THERE ARE ALSO COSTS COMPLETELY DISALLOWED BY COST REPORT RULES SUCH AS BAD DEBT EXPENSE, MARKETING, CRNA'S, AND INTEREST EXPENSE. DUE TO THESE EXCLUSIONS, ADDITIONAL SHORTFALL IS REALIZED.
		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 ST. LUKE'S FOLLOWS THE CHA GUIDELINES IN REPORTING COMMUNITY BENEFITS AND THEREFORE ANY MEDICARE SHORTFALL (AS CALCULATED INCLUDING OUR NON-COST REPORT ENTITIES) IS EXCLUDED FROM OUR COMMUNITY BENEFIT REPORT. HOWEVER, MEDICARE IS THE ORGANIZATION'S LARGEST PAYER AND PATIENTS WITH MEDICARE COVERAGE ARE ACCEPTED REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED FROM PROVIDING THE SERVICES. THIS BASIS THEREFORE MEANS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A KEY ADVANTAGE FOR OUR COMMUNITY.
		PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. AT SUCH TIME AS THE ORGANIZATION SENDS THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY SHALL REFLECT THE REDUCED-PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS. AVERA ST. LUKE'S DOES NOT REPORT ANY DATA TO ANY OF THE CREDIT AGENCIES, HOWEVER, THE COLLECTION AGENCIES AVERA ST. LUKE'S UTILIZES MAY REPORT TO THE CREDIT AGENCIES. ANY EXTENDED PAYMENT PLANS OFFERED BY THE HOSPITAL, OR THE HOSPITAL'S REPRESENTATIVE, IN SETTLING THE OUTSTANDING BILLS OF PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE INTEREST-FREE SO LONG AS THE REPAYMENT SCHEDULE IS MET.
		PART VI, LINE 2: HEALTH CARE NEEDS ARE ASSESSED THROUGH VARIOUS METHODS. GIVEN ABERDEEN IS A REGIONAL CENTER/HUB AND THE THIRD LARGEST CITY IN SOUTH DAKOTA, AVERA ST. LUKE'S IS INTEGRALLY INVOLVED WITH COMMUNITY ORGANIZATIONS, UNIVERSITIES/COLLEGES, SCHOOLS, STATE PROGRAMS AND LOCAL GOVERNMENTS. THE NEXT LARGEST HOSPITAL IS 100 MILES FROM ABERDEEN AND MOST OF THE TOWNS WITHIN OUR REGION HAVE A POPULATION OF LESS THAN 2,000. BY WORKING WITH ALL IN OUR REGION, WE ARE ABLE TO DETERMINE HEALTH NEEDS AND PROVIDE PROGRAMS AND SOLUTIONS WHERE POSSIBLE. ON A MORE FORMAL BASIS, OUR SYSTEM IS PRESENTLY ORGANIZING AND CONDUCTING A COMMUNITY NEEDS ASSESSMENT. ADDITIONALLY, WE ARE PARTICIPATING IN A COMMUNITY NEEDS ASSESSMENT WITH NORTHERN STATE UNIVERSITY. MANY OF OUR HEALTHCARE PROFESSIONALS IN THE AREA OF SOCIAL WORK, DIABETES, HOME HEALTH AND HOSPICE ALSO PROVIDE VALUABLE INSIGHT TO COMMUNITY AND REGIONAL NEEDS.
		PART VI, LINE 3: THE ORGANIZATION UTILIZES VARIOUS METHODS. ADMITTING AREAS HAVE SIGNS/POSTERS NOTING CHARITY CARE AND FINANCIAL ASSISTANCE. AVERA ST. LUKE'S AND AVERA HEALTH UTILIZE THE INTERNET TO ADDRESS FINANCIAL ASSISTANCE. SOCIAL WORKERS ARE IN DIRECT CONTACT WITH PATIENTS AND MAKE REFERRALS TO THE BUSINESS OFFICE FOR FINANCIAL ASSISTANCE AND IN MANY CASES, WORK DIRECTLY WITH THE PATIENT ON VARIOUS GOVERNMENT PROGRAMS WHICH MAY BE AVAILABLE AND HELP WITH APPLICATIONS. FOR THOSE WHO RECEIVE BILLS FOR SERVICES AND HAVE CONCERNS ABOUT THEIR ABILITY TO PAY, FINANCIAL COUNSELORS WORK DIRECTLY WITH THEM ON FINANCIAL ASSISTANCE. WE HAVE BROCHURES AVAILABLE TO ALL AND TREAT ALL WITHOUT REGARD TO THEIR ABILITY TO PAY.
		PART VI, LINE 4: ABERDEEN IS THE THIRD LARGEST CITY IN SOUTH DAKOTA. THE RECENT 2010 CENSUS REFLECTED A POPULATION OF APPROXIMATELY 26,000. OUR PRIMARY SERVICE AREA CONSISTS OF THE FOLLOWING COUNTIES: BROWN, MARSHALL, DAY, FAULK, EDMUNDS, MCPHERSON, SPINK AND DICKEY COUNTY IN NORTH DAKOTA. THE POPULATION OF THIS AREA IS APPROXIMATELY 64,000. OUR SECONDARY SERVICE AREA INCLUDES OTHER CLOSE BY COUNTIES. THIS LARGE SERVICE AREA IS DUE TO OUTREACH AND THE SCOPE OF SPECIALTY SERVICES OFFERED BY AVERA ST. LUKE'S FOR WHICH IF NOT OFFERED, A PATIENT WOULD TRAVEL UP TO 200 MILES FOR THE SAME SERVICE. GIVEN WE ARE A RURAL COMMUNITY IN THE TRUEST SENSE; WE HAVE A VERY AGED POPULATION. MANY OF THE PATIENTS WITHIN THIS REGION ARE MEDICARE AGE. THE CLOSEST HOSPITAL IS 40 TO 100 MILES AWAY AND HAVE LIMITED SERVICES AND ARE CRITICAL ACCESS HOSPITALS SERVED BY LIMITED PHYSICIANS. PATIENT DEMOGRAPHICS WITHIN THE REGION WOULD INDICATE THAT AFTER YOU CONSIDER THOSE PATIENTS ADMITTED TO THE SMALLER HOSPITALS, THE MAJORITY OF THE REST SEEK SERVICES AT AVERA ST. LUKE'S. THE POPULATION IN THE PRIMARY SERVICE COUNTIES RANGE FROM 2,459 TO 36,531. CENSUS DATA FOR 2010 AND 2009 ESTIMATES CONTAINS MANY DATA ELEMENTS, THEREFORE, WILL COMMENT ON BROWN COUNTY (LOCATION OF AVERA ST. LUKE'S), SPINK COUNTY (SECOND LARGEST IN PRIMARY SERVICE AREA WITH GROWTH) AND MCPHERSON COUNTY (DUE TO AGED POPULATION). % CHANGE IN POP. % OVER 65 NON-WHITE POP. % STATE OF SD 7.6% 14.4 12.1BROWN COUNTY 3.02 16.5 5.5 SPINK COUNTY -12.07 19.8 3.1MCPHERSON COUNTY -15.32 30.0 .07MEDIAN HOUSEHOLD INCOMESTATE OF SD 46,244BROWN COUNTY 43,140SPINK COUNTY 41,918MCPHERSON COUNTY 31,709AS THE ABOVE INDICATE, OUR REGION HAS EXPERIENCED ESSENTIALLY LITTLE GROWTH AND THE PERCENT OVER 65 YEARS OLD IS HIGH COMPARED TO THE STATE AVERAGE. THE HIGH AVERAGE AGE CORRELATES WITH MEDICARE ADMISSIONS BEING APPROXIMATELY 50% OF TOTAL ADMISSIONS. MEDICAID ADMISSIONS, INCLUDING BABIES, TOTALED 790 OR 12% OF ALL ADMISSIONS. IN ADDITION TO MEDICARE AND MEDICAID, THERE IS A COUNTY INDIGENT PROGRAM WHICH RESULTED IN APPROXIMATELY $1,120,000 OF ASSISTANCE AT CHARGE AND WAS FOR 164 PATIENTS.FROM AN UNEMPLOYMENT STANDPOINT, SOUTH DAKOTA AND OUR REGION HAS FAIRED MUCH BETTER THAN THE US. WITHIN THE PRIMARY SERVICE AREA, CURRENT UNEMPLOYMENT RATES RANGE FROM A LOW OF 4.2% IN BROWN COUNTY TO A HIGH OF 9.1% IN DAY COUNTY.
		PART VI, LINE 6: AVERA ST. LUKE'S IS A REGIONAL FACILITY WITHIN AVERA HEALTH SYSTEM. WE ARE A HEALTH MINISTRY COSPONSORED BY THE BENEDICTINE SISTERS OF YANKTON, SOUTH DAKOTA AND THE PRESENTATION SISTERS OF ABERDEEN, SOUTH DAKOTA. OUR HEALTH MINISTRY IS ROOTED IN THE GOSPEL AND REQUIRES US TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES. AVERA ST. LUKE'S VISION IS TO BE AN EXCEPTIONAL HEALTH CARE ORGANIZATION FOR PATIENTS TO RECEIVE CARE, PHYSICIANS TO PRACTICE AND EMPLOYEES TO WORK. THE ORGANIZATION'S VALUES ARE COMPASSION, HOSPITALITY AND STEWARDSHIP.OUR GOVERNING BODY CONSISTS OF 16 MEMBERS WHO ARE PHYSICIANS, COMMUNITY AND REGIONAL RESIDENTS AND SISTER REPRESENTATIVES FROM THE PRESENTATION AND BENEDICTINE ORDERS. IN ADDITION, TWO EMPLOYEES (ONE PHYSICIAN AND THE CEO) SERVE ON THE BOARD. THE GOVERNING BODY INCLUDED ONE SISTER WHO REPRESENTS BOTH ORDERS AND IS A SYSTEM REPRESENTATIVE. IN ADDITION TO THE GOVERNING BODY, WE HAVE VARIOUS ADVISORY BOARDS. THESE INCLUDE: CITIZEN'S ADVISORY BOARD, FOUNDATION BOARD AND HOME HEALTH, HOSPICE, AND PALLIATIVE CARE ADVISORY BOARD. MEDICAL STAFF PRIVILEGES CAN BE EXTENDED TO QUALIFIED PHYSICIANS BASED ON RECEIVING APPROVAL OF THEIR APPLICATION AND CREDENTIALS BY THE MEDICAL DENTAL STAFF AND THEN THE HOSPITAL GOVERNING BODY. THE HOSPITAL'S GOVERNING BODY THEN TAKES INTO ACCOUNT OTHER FACTORS RELATED TO OVERALL COMMUNITY NEED AND HOW A PHYSICIAN WOULD IMPACT THE HOSPITAL'S OVERALL ABILITY TO FULFILL THE MISSION.AVERA ST. LUKE'S MISSION AND VALUES ENSURE OUR FOCUS IS ON THE PATIENT, FAMILY, EMPLOYEES, PHYSICIAN, THOSE IN NEED, VISITORS AND OUR REGION AS A WHOLE. THE VALUE OF STEWARDSHIP REQUIRES THE ORGANIZATION TO USE ALL RESOURCES IN A WAY THAT FULFILLS THE MISSION AND VALUES. EACH YEAR, OUR OPERATING AND CAPITAL BUDGETS ARE BASED ON VARIOUS ASSUMPTIONS THAT IN THE END PROVIDE THE NEEDED RESOURCES AND TAKE INTO ACCOUNT CHARITY CARE, PATIENT CARE, TECHNOLOGY, EDUCATION, COMMUNITY SERVICES, EMPLOYEE BENEFIT AND COMPENSATION PLANS AND PROGRAMS FOR MEETING THE REGION'S NEEDS. ALL SURPLUS FUNDS ARE USED AND MAINTAINED TO PROVIDE FOR BOTH CURRENT AND FUTURE NEEDS.SPECIFIC EXAMPLES OF HOW WE FURTHER OUR EXEMPT PURPOSE INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING:A. THE ONLY INPATIENT REHABILITATION UNIT WITHIN 200 MILES.B. THE ONLY INPATIENT PSYCHIATRIC UNIT WITHIN 200 MILESC. INTERVENTIONAL CARDIOLOGY AND RADIOLOGY SERVICES. THESE SERVICES ALLOW US TO MEET PATIENT NEEDS WHEN CARE IS CRITICAL TO THEIR SURVIVAL AND MUST BE DELIVERED ON A VERY TIMELY BASIS.D. AIR AMBULANCE TO TRANSPORT PATIENTS TO OUR FACILITY OR 200 MILES TO TERTIARY FACILITIES.E. END STAGE RENAL DISEASE PROGRAM WHICH SERVES OUR BROAD REGION WITH THE NEXT CLOSEST FACILITY BEING 100 MILES AWAY. ADDITIONALLY, WE EMPLOYEE A FULL-TIME NEPHROLOGIST TO CARE FOR THE PATIENTS ALONG WITH OTHERS WHO REQUIRE INTENSIVE PHYSICIAN CARE.F. A 24 HOUR EMERGENCY ROOM WHICH TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. THE ER IS STAFFED BY PHYSICIANS 24 HOURS PER DAY.G. PROVISION OF A MULTITUDE OF EDUCATIONAL AND TRAINING PROGRAMS FOR HEALTHCARE PROFESSIONALS AND REGIONAL RESIDENTS. THE REGION WAS JUST AWARDED AN AREA HEALTH EDUCATION CENTER BY THE SOUTH DAKOTA SCHOOL OF MEDICINE AND WILL BE LOCATED IN ABERDEEN. THE AWARD WAS BASED ON APPLICATIONS AND INTERVIEWS WITHIN THE STATE AND WAS A COLLABORATIVE EFFORT OF MANY HEALTHCARE AND NON-HEALTHCARE ORGANIZATIONS WITHIN THE REGION WITH TWO BEING 100 MILES FROM ABERDEEN.H. AVERA ST. LUKE'S IS CURRENTLY A RURAL REFERRAL CENTER AND SOLE COMMUNITY HOSPITAL. THE NEAREST LIKE HOSPITALS ARE TERTIARY FACILITIES 200 MILES AWAY BY GROUND AND APPROXIMATELY 140 MILES BY AIR.I. AVERA ST. LUKE'S PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS AND EFFORTS TO BETTER THE REGION. LEADERSHIP OF THE ORGANIZATION IS ON BOARDS OF MANY EXEMPT ORGANIZATIONS (SALVATION ARMY, YMCA, FOUNDATIONS, COLLEGE/UNIVERSITY ADVISORY BOARDS, YOUTH ADULT PARTNERSHIP OF ABERDEEN).J. OUR FOUNDATION BOARD WORKS DILIGENTLY TO NOT ONLY ATTRACT OUTSIDE FUNDS BUT TO ENSURE THEY MEET THE NEEDS OF OUR ORGANIZATION AND OVERSEES THEIR USE.K. OUR AUXILIARY AND VOLUNTEERS PROVIDE OPPORTUNITIES FOR OVER 400 INDIVIDUALS. THE AUXILIARY PROVIDES ANNUAL SCHOLARSHIPS OF $500 FOR STUDENTS ENTERING HIGHER EDUCATION IN HEALTH RELATED FIELDS. IN FISCAL YEAR 2011, 23,307 HOURS OF SERVICE WERE PROVIDED TO AVERA ST. LUKE'S BY VOLUNTEERS WHICH REDUCES COSTS.L. PROVIDE ASSISTANCE TO SMALL RURAL HOSPITALS (CRITICAL ACCESS HOSPITALS) WITHIN THE REGION THROUGH VARIOUS PROGRAMS, MANAGEMENT AGREEMENTS, COMPUTER SYSTEMS, EDUCATIONS AND OTHER SERVICES TO ASSIST IN KEEPING THEIR AREA'S PATIENTS IN THE LOCAL COMMUNITY WHEN POSSIBLE.M. RECRUITMENT OF SPECIALISTS IN NEPHROLOGY, NEUROSURGERY, NEUROLOGY, CARDIOLOGY AND PSYCHIATRY TO MEET THE REGION'S NEED IN ORDER TO ELIMINATE TRAVEL OF 200 MILES TO OBTAIN THESE SERVICES.N. DEVELOPMENT AND SUBSIDY OF VARIOUS RURAL CLINICS TO MEET NEEDS IN THOSE COMMUNITIES.O. DEVELOPMENT OF A LOCAL CLINIC TO PROVIDE PRIMARY HEALTH CARE (NOT URGENT OR EMERGENCY CARE) TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY IN A SETTING THAT IS CONDUCIVE TO WALK-IN FOR A VERY MINIMAL COST (LESS THAN $60). THIS CLINIC IS STAFFED BY MID-LEVEL PROVIDERS (PA/NURSE PRACTIONERS) AND IS OPEN ON WEEKEND AND CERTAIN HOLIDAYS TO ALL AND INSURANCE BILLING IS PROVIDED.P. CHEMICAL ADDICTION SERVICES ON AN OUTPATIENT BASES ARE PROVIDED TO THE REGION AND STATE. OUR WORTHMORE PROGRAM IS WELL KNOWN AND RESPECTED WITHIN THE REGION AND STATE AND IS THE CLOSEST PROGRAM WITHIN 150-200 MILES. WE CONTRACT WITH THE STATE FOR PATIENTS WHO MEET THEIR QUALIFICATION GUIDELINES AND WORK WITH GOVERNMENTAL AGENCIES WITHIN THE REGION AND STATE. Q. PROVIDE DRUG AND ALCOHOL PREVENTION PROGRAMS TO THE LOCAL SCHOOLS THROUGH VARIOUS CONTRACTS. OUR INVOLVEMENT STARTED WHEN THE PREVIOUS PROVIDER DISCONTINUED THEIR CONTRACT.R. PROVIDE HOME CARE (HOMEMAKER) SERVICES TO THE REGION THROUGH A STATE CONTRACT. MANY YEARS AGO, THE STATE PROVIDED THESE SERVICES BUT DISCONTINUED THEIR DIRECT INVOLVEMENT AND OPTED FOR CONTRACTING WITH REGIONAL PROVIDERS. TO MEET THEIR NEEDS, AVERA ST. LUKE'S THEN CONTRACTED WITH LOCAL PROVIDERS IN THE REAL RURAL AREAS OF THE REGION TO ENSURE COVERAGE COULD BE PROVIDED TO THEIR RESIDENTS.
		PART VI, LINE 7: THE COMMUNITIES IN WHICH AVERA OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFIT NEEDS AND IN KEEPING WITH THE CATHOLIC HEALTHCARE ASSOCIATION GUIDELINES EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE AVERA CENTRAL OFFICE ADVOCATES FOR ALL ON COMMUNITY BENEFIT RELATED MATTERS OF STATE, REGIONAL, AND NATIONAL IMPORTANCE.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
AVERA ST LUKE'S

Employer identification number
46-0224598

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) NORTHERN STATE FOUNDATION620 15TH AVE SE ABERDEEN,SD57401	23-7002314	501(C)(3)	166,500	GENERAL SUPPORT
(2) ABERDEEN RIDE LINE205 N 4TH STREET ABERDEEN,SD57401	46-6000010	501(C)(3)	12,960	GENERAL SUPPORT
(3) ABSOLUTELY ABERDEEN416 PRODUCTION STREET NORTH ABERDEEN,SD57401	52-2424588	501(C)(6)	10,000	GENERAL SUPPORT
(4) PRESENTATION COLLEGE1500 N MAIN ABERDEEN,SD57401	52-2424588	501(C)(3)	163,800	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) MEDICAL SCHOLARSHIPS	4	24,000
(2) SCHOLARSHIPS	9	5,000

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE I, PART I, LINE 2: AVERA ST. LUKE'S POLICY IS TO PROVIDE GRANTS/CONTRIBUTIONS TO NOT-FOR-PROFIT ENTITIES AND GOVERNMENTAL DIVISIONS THAT BENEFIT THE COMMUNITY AND REGION THROUGH PROGRAMS AND ACTIVITIES. THE ORGANIZATION ALSO PROVIDES SCHOLARSHIPS TO MEDICAL STUDENTS AND OTHER STUDENTS IN THE COMMUNITY. SCHOLARSHIPS ARE GIVEN TO SCHOOLS TO HELP MONITOR THE USE OF THE FUNDS.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) TAGE BORN	(i) (ii)	715,854 0	45 0	118,183 0	12,250 0	23,898 0	870,230 0	0 0
(2) RON JACOBSON	(i) (ii)	0 522,240	0 0	0 10,853	0 12,250	0 16,141	0 561,484	0 0
(3) GEOFFREY DURST	(i) (ii)	191,273 0	20 0	1,785 0	4,594 0	20,265 0	217,937 0	0 0
(4) KC DEBOER	(i) (ii)	214,231 0	20 0	9,094 0	11,447 0	18,105 0	252,897 0	0 0
(5) JOHN FRITZ MD	(i) (ii)	292,600 0	30,020 0	15,612 0	5,635 0	16,253 0	360,120 0	0 0
(6) LALIT VADLAMANI	(i) (ii)	974,618 0	200,020 0	105,435 0	12,250 0	30,394 0	1,322,717 0	0 0
(7) SHAHID CHAUDHARY	(i) (ii)	977,010 0	50,020 0	1,458 0	12,250 0	19,291 0	1,060,029 0	0 0
(8) NAVIN GUPTA	(i) (ii)	895,016 0	100,020 0	77,097 0	12,250 0	25,395 0	1,109,778 0	0 0
(9) FAROOK KIDWAI	(i) (ii)	814,570 0	20 0	64,631 0	12,037 0	1,507 0	892,765 0	0 0
(10) CHRISTINE STEHLY	(i) (ii)	670,636 0	20 0	118,131 0	12,250 0	21,105 0	822,142 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
SUPPLEMENTAL INFORMATION	PART III	SCHEDULE J, PART I LINE 3: THE PRESIDENT/CEO'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, AVERA HEALTH. AVERA ST. LUKE'S RELIED ON THE RELATED ORGANIZATION FOR DETERMINING THE COMPENSATION FOR THE PRESIDENT/CEO USING THE METHODS DESCRIBED IN PART I, LINE 3.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) FAROOK KIDWAI COMMUNITY SERVICE		X	150,000	61,538		No	Yes		Yes
(2) NAVIN GUPTA MD COMMUNITY SERVICE		X	200,000	31,590		No	Yes		Yes
(3) TAGE BORN MD COMMUNITY SERVICE		X	300,000	153,846		No	Yes		Yes
(4) CHRISTINE STEHLY COMMUNITY SERVICE		X	300,000	153,846		No	Yes		Yes


Total ............... $				400,820

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Identifier	Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6		THE SOLE MEMBER OF THE ORGANIZATION IS AVERA HEALTH, A NONPROFIT CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF SOUTH DAKOTA AND EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.
FORM 990, PART VI, SECTION A, LINE 7A		AVERA HEALTH, AS THE SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B		AVERA HEALTH HAS THE FOLLOWING RIGHTS AS THE MEMBER. 1) TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE STATEMENTS OF PHILOSOPHY, MISSION AND VALUES OF CORPORATION; 2) TO INITIATE THE ADOPTION, AMENDMENT OR REPEAL OF ANY PROVISION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CORPORATION, AND TO GIVE FINAL APPROVAL OF ANY SUCH ACTION WITH RESPECT THERETO; 3) TO APPROVE AND ACT UPON THE ALIENATION OF REAL PROPERTY AND PRECIOUS ARTIFACTS UNDER THE CANONICAL STEWARDSHIP OF THE SISTERS OF THE PRESENTATION OF THE BLESSED VIRGIN MARY OF ABERDEEN, SOUTH DAKOTA ("PRESENTATION SISTERS") OR THE BENEDICTINE SISTERS OF SACRED HEART MONASTERY ("BENEDICTINE SISTERS"), PURSUANT TO THE POLICIES ESTABLISHED BY THE MEMBER; 4) TO APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION, OR THE DIVESTITURE OF A SPONSORED WORK OR MINISTRY ASSOCIATED WITH THE CORPORATION; 5) TO APPROVE THE CREATION OF NEW SPONSORED WORKS OR MINISTRIES TO BE CONDUCTED BY OR UNDER THE AUTHORITY OF THE CORPORATION; 6) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE BOARD OF DIRECTORS OF THE CORPORATION. 7) TO APPOINT AND/OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION. 8) TO APPROVE OPERATING/CAPITAL BUDGETS AND STRATEGIC PLANS OF THE CORPORATION. 9) TO APPROVE EXPENDITURES OUTSIDE OF OPERATING AND CAPITAL BUDGETS EXCEEDING DEFINED THRESHOLDS ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 10) TO APPROVE ACQUISITIONS, SALES AND LEASES, ACCORDING TO POLICY WHICH MAY BE ADOPTED FROM TIME TO TIME BY THE MEMBER. 11) TO ESTABLISH AND MAINTAIN EMPLOYEE BENEFIT PROGRAMS. 12) TO ESTABLISH AND MAINTAIN INSURANCE PROGRAMS. 13) TO APPROVE MAJOR COMMUNITY FUND DRIVES. 14) TO APPROVE THE APPOINTMENT OF AUDITORS. 15) TO ADOPT POLICIES DESIGNED TO EFFECTUATE THE RESERVED POWERS OF THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11		THE FORM 990 IS REVIEWED BY THE CEO AND CFO. AFTER INITIAL REVIEWS, A DRAFT IS PROVIDED TO THE FINANCE COMMITTEE FOR FINAL REVIEW. 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 15B	THE CEO IS COMPENSATED BY AVERA HEALTH. ANNUALLY THE COMPENSATION COMMITTEE OF AVERA HEALTH, WHICH IS COMPRISED OF SIX (6) SYSTEM MEMBERS APPOINTED BY THE RELIGIOUS ORDERS, MEETS WITH AN INDEPENDENT CONSULTANT REGARDING FAIR MARKET VALUE OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE APPROVES ALL SALARIES BASED ON COMPARABLE DATA AND DOCUMENTS THE BASIS FOR THEIR DECISION IN MEETING MINUTES. IN 2004 THE BOARD OF DIRECTORS ADOPTED A RESOLUTION TO INITIATE THE PHYSICIAN RELATIONS COMMITTEE TO REVIEW ALL PHYSICIAN RELATED TRANSACTIONS AND COMPENSATION. IN FEBRUARY 2010 THE BOARD OF DIRECTORS ADOPTED A RESOLUTION TO CHANGE THE NAME OF THE PHYSICIAN RELATIONS COMMITTEE TO PHYSICIAN RELATIONS/EXECUTIVE COMPENSATION COMMITTEE TO REVIEW PHYSICIAN RELATED TRANSACTIONS AND COMPENSATION RELATED TO PHYSICIANS, OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. GIVEN SALARIES OF OTHER OFFICERS AND KEY EMPLOYEES WERE FROZEN IN FISCAL YEAR 2010 A REVIEW DID NOT TAKE PLACE. THE PRIOR YEAR PROCESS OF CONTRACTING WITH AN OUTSIDE CONSULTANT TO GATHER WAGE AND MARKET DATA WAS USED. INFORMATION IS PROVIDED TO THE CONSULTANT FOR LEADERSHIP POSITIONS THAT REFLECT THE LEADER'S AREA OF RESPONSIBILITIES INCLUDING THE POSITION TITLE AND EDUCATION REQUIREMENTS, REPORTING STRUCTURE, NUMBER OF FTE'S, TOTAL REVENUE AND EXPENSES AND YEARS OF EXPERIENCE. THIS INFORMATION IS USED INTERNALLY TO ASSIST IN DETERMINING WAGES BASED ON BUDGET AND INTERNAL EQUITY. FINAL WAGES DECISIONS WERE MADE BY THE CEO AND APPROVED COLLECTIVELY BY THE BOARD OF DIRECTORS AS PART OF THE ANNUAL BUDGET. IN JANUARY 2011, THE COMMITTEE REVIEWED ALL LEADERSHIP SALARIES BASED ON MARKET DATA FROM THE SAME SOURCES USED IN PRIOR YEARS. FORM 990, PART VI, LINE 16B: THERE IS NO WRITTEN POLICY OR PROCEDURE SINCE IN THE EVENT OF ANY SUCH PROPOSED TRANSACTION THE BOARD OR A COMMITTEE WITH DELEGATED AUTHORITY REVIEWS ALL MATERIALS, VALUATIONS AND OPERATIONAL ASPECTS FOR ANY PROPOSED TRANSACTION. SUCH TRANSACTION WOULD BE EVALUATED IN ACCORDANCE WITH THE EXEMPT STATUS OF THE ORGANIZATION AND ITS APPLICABLE PURPOSES. ANY TRANSACTION ALSO WOULD BE APPROVED BY THE BOARD AND THE MEMBER.
	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE ARE AVAILABLE TO THE GENERAL PUBLIC.
	FORM 990, PART VII:	IN ADDITION TO THE TIME SERVED AT AVERA ST. LUKE'S, SISTER JOANN STURZL SERVES 1.3 HOURS PER WEEK AT AVERA MARSHALL, A RELATED ORGANIZATION.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 6,807,517. CAPITAL TRANSFER -473,387. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 243,793. BOOK/TAX ADJUSTMENT ON INVESTMENT IN ENDOSCOPY LLC 512,756. LOSS FOR RETIREMENT OF DEBT -42,706. DECREASE IN NONCONTROLLING INTEREST -24,115. TOTAL TO FORM 990, PART XI, LINE 5: 7,023,858.
	FORM 990, PART XII, LINE 2C:	THE AUDIT COMMITTEE OF AVERA HEALTH, PARENT ORGANIZATION, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA ST. LUKE'S.
	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 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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

AVERA ST LUKE'S

Employer identification number

46-0224598

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) AVERA HEALTH 3900 WEST AVERA DRIVE SUITE 300 SIOUX FALLS,SD57108 46-0422673	PROMOTION OF HEALTH	SD	501(C)(3)	LINE 9	N/A		No
(2) AVERA WORKERS' COMPENSATION TRUST PO BOX 38 YANKTON,SD57078 46-0407148	ECONOMICAL COVERAGE OF WORKERS' COMPENSATION CLAIMS	SD	501(C)(3)	LINE 11B, II	AVERA HEALTH		No
(3) AVERA ST ANTHONY'S HOSPITAL 300 N 2ND STREET ONEILL,NE68763 47-0463911	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3	AVERA HEALTH		No
(4) AVERA HOLY FAMILY 826 NORTH 8TH STREET ESTHERVILLE,IA51334 42-0680370	HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3	AVERA HEALTH		No
(5) AVERA HOLY FAMILY FOUNDATION 826 NORTH 8TH STREET ESTHERVILLE,IA51334 42-1317452	FUNDRAISING	IA	501(C)(3)	LINE 9	AVERA HOLY FAMILY		No
(6) AVERA MARSHALL 300 S BRUCE STREET MARSHALL,MN56258 41-0919153	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3	AVERA HEALTH		No
(7) AVERA MARSHALL FOUNDATION 300 S BRUCE STREET MARSHALL,MN56258 41-1784801	FUNDRAISING	MN	501(C)(3)	LINE 7	AVERA MARSHALL		No
(8) ST BENEDICT HEALTH CENTER 401 WEST GLYNN DRIVE PARKSTON,SD57366 46-0226738	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH		No
(9) ST BENEDICT HEALTH CENTER FOUNDATION WEST GLYNN DRIVE PO BOX B PARKSTON,SD57366 46-0458725	SUPPORT HEALTH RELATED SERVICES	SD	501(C)(3)	LINE 11A, I	ST BENEDICT HEALTH CENTER		No
(10) AVERA MCKENNAN 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS,SD57117 46-0224743	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH		No
(11) AVERA QUEEN OF PEACE HOSPITAL 525 NORTH FOSTER MITCHELL,SD57301 46-0224604	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH		No
(12) SACRED HEART HEALTH SERVICES 501 SUMMIT STREET YANKTON,SD57078 46-0225483	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH		No
(13) SACRED HEART RURAL HEALTH CLINICS 501 SUMMIT STREET YANKTON,SD57078 46-0423930	CLINIC SERVICES	SD	501(C)(3)	LINE 3	SACRED HEART HEALTH SERVICES		No
(14) HEALTH MANAGEMENT SERVICES 501 SUMMIT STREET YANKTON,SD57078 46-0399291	ADULT DAYCARE AND HOMEMAKING SERVICES	SD	501(C)(3)	LINE 9	SACRED HEART HEALTH SERVICES		No
(15) LEWIS AND CLARK HEALTH EDUCATION AND SERVICE AGENCY 1000 W 4TH STREET SUITE 9 YANKTON,SD57078 46-0337013	HEALTHCARE EDUCATION	SD	501(C)(3)	LINE 9	SACRED HEART HEALTH SERVICES		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) SURGICAL ASSOCIATES ENDOSCOPY CENTER LLC 310 S PENN ABERDEEN,SD57401 46-0461429	SURGICAL ASSOCIATES/ENDOSCOPY SERVICES	SD	N/A	RELATED	474,867	253,265		No		Yes		51.000 %
(2) AVERA HOME MEDICAL EQUIPMENT LLC 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS,SD57117 46-0488198	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(3) MIDWEST REGIONAL IMAGING SERVICES LLC 1325 S CLIFF AVE PO BOX 5045 SIOUX FALLS,SD57117 47-0874983	HEALTH CARE - MEDICAL IMAGING	SD	N/A
(4) MERSCO MEDICAL OF PIERRE LLC 329 E DAKOTA PIERRE,SD57501 46-0444002	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(5) AVERA HOME MEDICAL EQUIPMENT OF FLOYD VALLEY HOSPITAL LLC 714 LINCOLN ST NE LEMARS,IA51031 82-0582350	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(6) AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC 602 CENTRAL AVE ESTHERVILLE,IA51334 20-1686097	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(7) AVERA HOME MEDICAL EQUIPMENT OF SIOUX CENTER LLC 38 19TH ST SW SIOUX CENTER,IA51250 75-3203100	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(8) AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC 1104 EAST COLLEGE DRIVE MARSHALL,MN56258 20-5271924	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(9) AVERA HOME MEDICAL EQUIPMENT OF SPENCER HOSPITAL LLC 2400 S MINNESOTA AVE SIOUX FALLS,SD57117 80-0619999	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A
(10) Q&M PROPERTIES LLC 525 NORTH FOSTER MITCHELL,SD57301 73-1652049	MEDICAL CLINIC BUILDING	SD	N/A
(11) HEART HOSPITAL OF SOUTH DAKOTA LLC 10720 SIKES PLACE SUITE 300 CHARLOTTE,NC28277 56-2143771	HEALTHCARE SERVICES	NC	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) ACCOUNTS MANAGEMENT INC 5132 S CLIFF AVE SUITE 101 SIOUX FALLS,SD57108 46-0373021	COLLECTION AGENCY	SD	N/A	C
(2) AVERA HEALTH PLANS INC 3900 WEST AVERA DRIVE SUITE 101 SIOUX FALLS,SD57108 46-0451539	HEALTH FINANCING AND HEALTH PLAN ADMINISTRATION	SD	N/A	C
(3) AVERA PROPERTY INSURANCE INC 610 W 23RD ST STE 1 PO BOX 38 YANKTON,SD57078 46-0463155	INSURANCE	SD	N/A	C
(4) VALLEY HEALTH SERVICES 501 SUMMIT STREET YANKTON,SD57078 46-0357149	MEDICAL EQUIPMENT	SD	N/A	C

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC	K	431,800	ACTUAL PAYMENTS
(2) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC	R	1,010,000	FINANCIAL STATEMENTS
(3) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC	A	80,386	ACTUAL PAYMENTS
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROMOTION OF HEALTH
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	14
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,771
6	Total number of volunteers (estimate if necessary) ....	6	220
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	400,264	289,209
9	Program service revenue (Part VIII, line 2g) .........	142,820,178	156,941,647
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,135,973	2,500,093
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-208,446	113,439
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	144,147,969	159,844,388
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	300,664	459,026
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	84,604,047	92,179,696
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 242,422
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	54,941,850	58,710,983
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	139,846,561	151,349,705
19	Revenue less expenses. Subtract line 18 from line 12......	4,301,408	8,494,683
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	184,646,524	199,660,556
21	Total liabilities (Part X, line 26)............	67,950,177	67,445,668
22	Net assets or fund balances. Subtract line 21 from line 20 .....	116,696,347	132,214,888

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 128,827,122 including grants of $ 459,026 ) (Revenue $ 156,941,647 )
	AVERA ST. LUKE'S MISSION IS TO PROVIDE ACUTE CARE AND LONG-TERM HEALTHCARE SERVICES INCLUDING SKILLED NURSING, CONGREGATE LIVING AND ASSISTED LIVING (MEDICAID CERTIFIED), OF WHICH THERE WERE 23,091 ACUTE PATIENT DAYS, 1,547 NURSERY PATIENT DAYS, 48,902 NURSING HOME RESIDENT DAYS, 112,715 CLINIC VISITS AND 210,339 OUTPATIENT VISITS. AVERA ST. LUKE'S 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, WAS $3,707,693 FOR THE YEAR ENDED JUNE 30, 2011. AVERA ST. LUKE'S ALSO PROVIDES COMMUNITY BENEFIT HEALTH ACTIVITIES AT LESS THAN OR AT NO COST TO SUPPORT THOSE IN THE AREA SERVED. THESE ACTIVITIES INCLUDE: DONATIONS/GRANTS, COMMUNITY EDUCATION PROGRAMS; SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND MEDICALLY UNDERSERVED; SUPPORT FOR RURAL CLINICS; NURSING STAFF FOR HEALTH CENTERS SERVING MINORITY POPULATIONS; AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING THE YEAR ENDED JUNE 30, 2011, SPECIFIC ACTIVITIES INCLUDED MEALS DELIVERED TO RESIDENTIAL HOMES; SENIOR RESOURCE PROGRAMS FOR BILLING ASSISTANCE; MEETING FACILITIES; PROGRAMS FOR PATIENTS AND FAMILIES SUFFERING FROM CANCER, DIABETES, BREATHING DISORDERS, MULTIPLE SCLEROSIS, AND OTHERS; ASSISTANCE TO HEALTH EDUCATORS; EMERGENCY HEALTHCARE PROVIDERS; WELLNESS PROGRAMS; AND HOUSING FAMILIES OF HOSPITALIZED PATIENTS.AS A MEMBER OF THE AVERA HEALTH SYSTEM, AVERA ST. LUKE'S 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 ST. LUKE'S ENGAGES IN ACTIVITIES (INCLUDING COMMUNITY NEEDS ASSESSMENT) DESIGNED TO IMPROVE THE HEALTH OF INDIVIDUALS AND COMMUNITIES IN RESPONSE TO A CALLING TO HEAL THE SICK, THE ELDERLY, AND THE OPPRESSED.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 128,827,122

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KC DEBOER VP HOSPITAL DIVISION	40.00	X		223,345	0	29,552
(19) JOHN FRITZ MD VP OUTREACH SVCS	40.00	X		338,232	0	21,888
(20) LALIT VADLAMANI PHYSICIAN	40.00		X	1,280,073	0	42,644
(21) SHAHID CHAUDHARY PHYSICIAN	40.00		X	1,028,488	0	31,541
(22) NAVIN GUPTA PHYSICIAN	40.00		X	1,072,133	0	37,645
(23) FAROOK KIDWAI PHYSICIAN	40.00		X	879,221	0	13,544
(24) CHRISTINE STEHLY PHYSICIAN	40.00		X	788,787	0	33,355

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	6,637,439	533,093	298,000

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		79,948
e	Government grants (contributions)1e		125,494

f	All other contributions, gifts, grants, and similar amounts not included above1f		83,767
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			289,209
			Business Code
2a	NET PATIENT SERVICES		621,110	153,407,458	153,407,458
b	OTHER REVENUE		624,100	2,218,700	2,218,700
c	INVESTMENT IN AVERA HE		900,099	840,622	840,622
d	INVESTMENT IN PARTNERS		900,099	474,867	474,867
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			156,941,647
3	Investment income (including dividends, interest
	and other similar amounts).....			206,995			206,995
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	569,106
b	Less: rental expenses	727,229
c	Rental income or (loss)	-158,123
d	Net rental income or (loss).......			-158,123			-158,123
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	2,299,578	3,500
b	Less: cost or other basis and sales expenses		9,980
c	Gain or (loss)	2,299,578	-6,480
d	Net gain or (loss)..........			2,293,098			2,293,098
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a		89,518
b	Less: cost of goods sold ..b		74,321
c	Net income or (loss) from sales of inventory..			15,197			15,197
Miscellaneous Revenue			Business Code
11a	INTEREST INCOME		900,099	256,365			256,365
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			256,365
12	Total revenue. See Instructions....			159,844,388	156,941,647	0	2,613,532


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........				1
2	Savings and temporary cash investments .......			11,147,575	2	10,885,608
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			20,337,349	4	22,863,699
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			607,474	5	400,820
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			1,671,591	7	1,342,888
8	Inventories for sale or use ..............			2,662,771	8	2,406,234
9	Prepaid expenses and deferred charges ............			1,313,375	9	1,272,613
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	193,926,597
b	Less: accumulated depreciation. .....	10b	115,912,542	76,340,261	10c	78,014,055
11	Investments—publicly traded securities ..........			3,392,212	11	3,519,056
12	Investments—other securities. See Part IV, line 11 ......			62,033,678	12	75,227,320
13	Investments—program-related. See Part IV, line 11 ..			601,306	13	314,451
14	Intangible assets .........			2,684,972	14	2,800,251
15	Other assets. See Part IV, line 11 ...........			1,853,960	15	613,561
16	Total assets. Add lines 1 through 15 (must equal line 34)...			184,646,524	16	199,660,556
17	Accounts payable and accrued expenses .			14,263,808	17	15,582,263
18	Grants payable ..........				18
19	Deferred revenue ..........				19	4,351
20	Tax-exempt bond liabilities ..........			48,393,292	20	47,588,507
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			84,048	21	85,311
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			5,209,029	25	4,185,236
26	Total liabilities. Add lines 17 through 25.....			67,950,177	26	67,445,668
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			114,946,793	27	129,621,895
28	Temporarily restricted net assets .....			1,224,504	28	2,066,816
29	Permanently restricted net assets .....			525,050	29	526,177
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			116,696,347	33	132,214,888
34	Total liabilities and net assets/fund balances .....			184,646,524	34	199,660,556