Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
AVERA HEALTH
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3900 WEST AVERA DRIVE NO 300
 
Room/suite
City or town, state or country, and ZIP + 4
SIOUX FALLS, SD57108
D Employer identification number

46-0422673
E Telephone number

G Gross receipts $ 74,838,894
F Name and address of principal officer:
JOHN PORTER
3900 WEST AVERA DRIVE NO 300
SIOUX FALLS,SD57108
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.AVERA.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1998
M State of legal domicile: SD
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROMOTION OF HEALTH
2 Check this box MediumBullet
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 13
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 409
6 Total number of volunteers (estimate if necessary) .... 6 13
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,686,753
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 435,247
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,772,674 13,930,641
9 Program service revenue (Part VIII, line 2g) ......... 40,864,118 56,880,853
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,201,853 3,097,724
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 11,426 384,343
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 47,850,071 74,293,561
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 2,238,460 5,903,271
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) 21,571,696 37,127,214
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet235,211    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 19,118,840 20,261,316
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 42,928,996 63,291,801
19 Revenue less expenses. Subtract line 18 from line 12...... 4,921,075 11,001,760
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 570,136,185 700,195,823
21 Total liabilities (Part X, line 26)............ 441,702,144 523,220,103
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 128,434,041 176,975,720
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: AVERA HEALTH IS A HEALTH MINISTRY ROOTED IN THE GOSPEL. OUR MISSION IS TO MAKE A POSITIVE IMPACT IN THE LIVES AND HEALTH OF PERSONS AND COMMUNITIES BY PROVIDING QUALITY SERVICES GUIDED BY CHRISTIAN VALUES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 58,178,856 including grants of $ 5,903,271 ) (Revenue $ 55,194,100 )
AVERA HEALTH DELIVERS HEALTH CARE TO INDIVIDUALS AND COMMUNITIES THROUGH A SYSTEM OF NEARLY 300 AFFILIATED HEALTH CARE FACILITIES, WHICH ARE REFERRED TO COLLECTIVELY AS "AVERA." AVERA, THE HEALTH MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS, SERVED THE PEOPLE OF EASTERN SOUTH DAKOTA AND SURROUNDING STATES WITH A WIDE SPECTRUM OF HEALTH SERVICES DELIVERED THROUGH HOSPITALS, LONG-TERM CARE FACILITIES, CLINICS AND OTHER HEALTH PROGRAMS.AVERA HEALTH VISIONWORKING WITH ITS PARTNERS, AVERA HEALTH SHALL PROVIDE A QUALITY, COST-EFFECTIVE HEALTH MINISTRY, WHICH REFLECTS GOSPEL VALUES. WE SHALL IMPROVE THE HEALTH CARE OF THE PEOPLE WE SERVE THROUGH A REGIONALLY INTEGRATED NETWORK OF PERSONS AND INSTITUTIONS.AVERA VALUESIN CARING FOR LIFE, THE AVERA COMMUNITY IS GUIDED BY THE GOSPEL VALUES OF COMPASSION, HOSPITALITY AND STEWARDSHIP.AVERA IS SPONSORED BY THE BENEDICTINE SISTERS OF YANKTON, S.D., AND THE PRESENTATION SISTERS OF ABERDEEN, S.D. IN ACCORD WITH ITS CATHOLIC MISSION, AVERA ADHERES TO "THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES".AVERA FACILITIES RETURN ANY REVENUES OVER EXPENSES THAT THEY RECEIVE TO THE PEOPLE IN THEIR COMMUNITIES IN THREE WAYS:WE PROVIDE CARE OF THOSE WHO CANNOT AFFORD TO PAY. AVERA AFFILIATES PROVIDE FREE OR DISCOUNTED HEALTH AND HEALTH-RELATED SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY ALL OR PART OF A BILL, INCLUDING PERSONS WHO ARE UNINSURED AND LOW-INCOME PATIENTS, USING INCOME-RELATED DISCOUNTS. AS THE NUMBER OF UNINSURED PERSONS GROWS, SO DOES THE NEED FOR CHARITY CARE, OR FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO THOSE WHO CANNOT AFFORD TO PAY.CHARITY CARE/PATIENT ASSISTANCE $15,411,759CHARITY CARE/PATIENT ASSISTANCE IS FREE OR DISCOUNTED HEALTH AND HEALTH-RELATED SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY ALL OR PART OF A BILL, INCLUDING PERSONS WHO ARE UNINSURED AND LOW-INCOME PATIENTS, USING AN INCOME-RELATED SCHEDULE. THE DOLLAR AMOUNT PROVIDED FOR CHARITY CARE IS BASED ON THE ACTUAL COST OF PROVIDING THAT SERVICE, NOT THE AMOUNT THAT WOULD HAVE BEEN CHARGED FOR THAT SERVICE. CHARITY CARE DOES NOT INCLUDE BAD DEBT.UNPAID COSTS OF GOVERNMENT AND OTHER PROGRAMS $ 19,906,722*MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP), LOCAL AND STATE GOVERNMENT PROGRAMS THAT REIMBURSE HEALTH CARE PROVIDERS FOR PERSONS NOT ELIGIBLE FOR MEDICAID AND OTHER GOVERNMENT PROGRAMS PROVIDE HEALTH COVERAGE FOR THOUSANDS OF INDIVIDUALS IN OUR REGION. HOWEVER, THEY GENERALLY DO NOT REIMBURSE HOSPITALS AND DOCTORS FOR THE FULL COSTS OF SERVICES. IN MANY INSTANCES, PAYMENT IS BASED ON DATA FROM PREVIOUS YEARS THAT DOESN'T ACCURATELY REFLECT THE RAPIDLY CHANGING NATURE OF HEALTH SERVICES, SUCH AS NEW PROCESSES, NEW EQUIPMENT, NEW TECHNOLOGIES AND RISING COSTS FOR SUPPLIES.*IN ACCORD WITH "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT" (ST. LOUIS: CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES, 2008), UNPAID COSTS OF MEDICARE ARE NOT INCLUDED IN THIS AMOUNT. THE AMOUNT OF UNPAID COSTS OF MEDICARE FOR THE FISCAL YEAR ENDING JUNE 30, 2011, WAS $17,621,834.ADDITIONAL COMMUNITY BENEFITS $35,554,330COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. THESE PROGRAMS AND SERVICES ARE NOT PROVIDED FOR MARKETING PURPOSES. A COMMUNITY BENEFIT MUST MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: IMPROVE ACCESS TO HEALTH CARE SERVICES; ENHANCE HEALTH OF THE COMMUNITY; ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE; OR RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. INCLUDED IN THIS CATEGORY ARE COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH ACTIVITIES, FINANCIAL AND IN-KIND CONTRIBUTIONS, COMMUNITY-BUILDING AND LEADERSHIP ACTIVITIES AND COMMUNITY-BENEFIT-OPERATIONS ACTIVITIES.TOTAL $70,872,811AVERA OPERATES UNDER THE PREMISE THAT SOCIAL AND INSTITUTIONAL WELLNESS ARE BEST PROMOTED THROUGH JOINT EFFORTS OF VARIOUS RELIGIOUS AND COMMUNITY-SPONSORED INSTITUTIONS. CHOOSING COLLABORATION AND EMPOWERMENT ENABLES US TO BE BETTER STEWARDS OF OUR HUMAN, FINANCIAL, TECHNICAL AND ENVIRONMENTAL RESOURCES.OUR CAREGIVERS ARE SUPPORTED BY THE RESOURCES AND EXPERTISE OF THE REGION'S LARGEST HEALTH SYSTEM. MANAGEMENT AND OTHER SUPPORT SERVICES ARE PROVIDED THROUGH THE AVERA CENTRAL OFFICE, AND AVERA'S FIVE REGIONAL CENTERS: AVERA ST. LUKE'S IN ABERDEEN, S.D.; AVERA MARSHALL REGIONAL MEDICAL CENTER IN MARSHALL, MINN.; AVERA QUEEN OF PEACE IN MITCHELL, S.D.; AVERA MCKENNAN IN SIOUX FALLS, S.D.; AND AVERA SACRED HEART IN YANKTON, S.D. AS A LEADING HEALTH SYSTEM IN THE REGION, AVERA IS COMMITTED TO MEETING THE NEEDS OF COMMUNITIES IT SERVES THROUGH THE PROVISION OF QUALITY HEALTH CARE SERVICES GUIDED BY CHRISTIAN VALUES AND BY MAKING A POSITIVE IMPACT ON THE COMMUNITY. AVERA HEALTH ACTS AS THE LEADER OF THE AVERA HEALTH MINISTRY, SERVING AS AN OVERALL PARENT TO SUPPORT ITS AFFILIATED TAX-EXEMPT HEALTH CARE ORGANIZATIONS. THROUGH AVERA HEALTH, AFFILIATES COLLABORATE TO IMPROVE THE LIVES AND HEALTH OF INDIVIDUALS AND OF THE COMMUNITIES WE SERVE. THIS COLLABORATION ALLOWS AFFILIATES TO ACCESS LEADING EDGE STRATEGIES AND EXPERTISE WHILE KEEPING ADMINISTRATIVE COSTS AS LOW AS POSSIBLE.AVERA HEALTH SERVES HEALTH CARE FACILITIES THAT ARE OWNED BY AVERA HEALTH AS WELL AS FACILITIES THAT ARE OWNED BY LOCAL COMMUNITIES. THROUGH AVERA HEALTH, AFFILIATES ARE ABLE TO SHARE COSTS OF MANAGEMENT, LEGAL AND OTHER SUPPORT SERVICES AMONG MANY FACILITIES RATHER THAN EACH FACILITY INCURRING THOSE COSTS SEPARATELY. AVERA HEALTH PROVIDES A VARIETY OF SERVICES FOR THE BENEFIT OF AFFILIATES INCLUDING COORDINATING THE DELIVERY OF HEALTH CARE SERVICE TO THE REGION, OVERALL STRATEGIC PLANNING, GROUP PURCHASING OF SUPPLIES AND SERVICES AT LOWEST POSSIBLE COST AND EDUCATION. AVERA HEALTH ALSO COORDINATES JOINT INVESTMENTS AND RISK-MANAGEMENT PROGRAMS FOR AFFILIATES.SOME OF THE SPECIFIC WAYS AVERA HEALTH HAS IMPROVED THE COMMUNITIES WE SERVE INCLUDE DURING THE YEAR ENDED JUNE 30, 2011 ARE:* PROVIDING SUPPORT SERVICES TO NEARLY 300 AFFILIATED HEALTH CARE FACILITIES* PROVIDING MORE THAN $5,140,711 (SHOWN ON FORM 990, PART IX, LINE 1) IN FINANCIAL SUPPORT FOR VARIOUS PROJECTS IN LOCAL COMMUNITIES* SPONSORING EDUCATION PROGRAMS INCLUDING A GERONTOLOGICAL CARE CONFERENCE, NURSING CONFERENCE, ETHICS CONFERENCE, PARISH NURSING CONFERENCE AND MORE
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 expensesMediumBullet$ 58,178,856
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
93
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
409
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ , VI
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
Yes
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
16
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JIM BRECKENRIDGE
3900 W AVERA DR STE 300
SIOUX FALLS,SD57108
(605) 322-4700
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) DR HERBERT A SALOUM
CHAIR
 5.20 X   X       1,625 0 0
(2) SISTER KATHLEEN CROWLEY
VICE CHAIR
 5.00 X   X       0 0 0
(3) SISTER LUCILLE WELBIG
DIRECTOR
 5.00 X           0 0 0
(4) DANIEL P MURPHY
DIRECTOR
 5.00 X           0 0 0
(5) BOB SUTTON
DIRECTOR
 5.00 X           0 0 0
(6) SISTER BARBARA MCTAGUE
DIRECTOR
 5.00 X           0 0 0
(7) SISTER MARY M THOMAS
DIRECTOR
 5.00 X           0 0 0
(8) SISTER MARY JAEGER
DIRECTOR
 5.00 X           0 0 0
(9) RODNEY W FOUBERG
DIRECTOR
 5.00 X           0 0 0
(10) MARK SHLANTA
DIRECTOR
 5.00 X           0 0 0
(11) SISTER DEBRA KOLECKA
DIRECTOR
 5.00 X           0 0 0
(12) DR KIM W JUNDT
DIRECTOR
 5.00 X           0 445,142 28,355
(13) MARK BUCHE
DIRECTOR
 5.00 X           0 0 0
(14) DR J MICHAEL BACHARACH
DIRECTOR
 5.00 X           0 0 0
(15) KEVIN CONLIN
DIRECTOR
 5.00 X           0 0 0
(16) JOHN PORTER
PRESIDENT & CEO
 40.00 X   X       1,273,176 0 28,024
(17) JAMES BRECKENRIDGE
SEC/TREAS & SRVP FINANCE
 40.00     X       614,049 0 19,566
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) FREDRICK SLUNECKA
CHIEF OPERATING OFFICER
 40.00       X     941,800 0 26,824
(19) DAVID ERICKSON
SR VP MEDICAL AFFAIR
 40.00         X   519,643 0 27,676
(20) RON JACOBSON
PRES/CEO-ST.LUKES
 1.00         X   533,093 0 26,824
(21) PAM REZAC
PRES/CEO-SACRED HEART
 1.00         X   469,679 0 29,676
(22) JEAN REED
SR VP STRATEGY/GOVERNANCE
 40.00         X   465,866 0 29,324
(23) THOMAS RASMUSSEN
PRES/CEO-QUEEN OF PEACE
 40.00         X   463,190 0 30,824














1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,282,121 445,142 247,093
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet47
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
NAVIGANT CONSULTING INC
4511 PAYSPHERE CIRCLE
CHICAGO,IL60674 		CONSULTANT 2,472,425
BVK
250 WEST CONVENTRY COURT
MILWAUKEE,WI53217 		MARKETING CONSULTANT 1,304,621
US BANK NATIONAL ASSOCIATION
600 NICOLLET MALL
MINNEAPOLIS,MN55402 		FINANCIAL MANAGEMENT 1,134,570
PRESENTATION CONVENT
1500 N 2ND STREET
ABERDEEN,SD57401 		SERVICES 884,745
SACRED HEART MONASTERY
1005 WEST 8TH STREET
YANKTON,SD57078 		SERVICES 658,473
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet34
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 319,141
d Related organizations...1d  
e Government grants (contributions)1e 1,708,747
f All other contributions, gifts, grants, and
similar amounts not included above1f 		11,902,753
g Noncash contributions included in lines 1a-1f:$ 603,923
h Total. Add lines 1a-1f.......MediumBullet 13,930,641
Program Service Revenue Business Code
2a SUPPORT SERVICES 561,000 54,338,093 52,643,909 1,694,184  
b INCOME FROM AFFILIATES 561,000 2,513,255 2,520,686 -7,431  
c EDUCATION & CONFERENCE 900,099 29,505 29,505    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 56,880,853
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 936,748     936,748
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 2,163,681 32,150
b Less: cost or other basis and sales expenses   34,855
c Gain or (loss) 2,163,681 -2,705
d Net gain or (loss)..........MediumBullet 2,160,976     2,160,976
8a Gross income from fundraising events (not including
$ 319,141
of contributions reported on line 1c). See Part IV, line 18 ...
a 886,005
b Less: direct expenses ...b 510,478
c Net income or (loss) from fundraising events..MediumBullet 375,527   375,527
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...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a OTHER INVESTMENT INCOM 900,099 8,816     8,816
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 8,816
12 Total revenue. See Instructions....MediumBullet 74,293,561 55,194,100 1,686,753 3,482,067
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
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 5,140,771 5,140,771
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 762,500 762,500
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 .... 1,943,181   1,943,181  
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 26,627,118 26,627,118    
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 8,556,915 8,556,915    
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ........... 690,592   690,592  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 4,153,722 3,811,141 342,581  
12 Advertising and promotion .... 1,047,836 1,047,836    
13 Office expenses ....... 3,739,059 3,241,701 481,693 15,665
14 Information technology ...... 10,432 10,432    
15 Royalties ..        
16 Occupancy ........... 772,990 586,533 186,457  
17 Travel ............ 1,031,198 904,101 127,097  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 440,090 363,947 76,143  
20 Interest ........... 477,067 477,067    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 3,347,793 2,605,844 741,949  
23 Insurance .............. 169,757 62,269 107,488  
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 GRANT PROGRAM EXPENDITU 2,473,525 2,473,525    
b MARKETING 1,294,912 1,294,912    
c FUNDRAISING EXPENSES 212,416     212,416
d UBI TAX 128,309   128,309  
e
f All other expenses 271,618 212,244 52,244 7,130
25 Total functional expenses. Add lines 1 through 24f 63,291,801 58,178,856 4,877,734 235,211
26 Joint costs. Check here MediumBullet 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 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 16,430,963 2 15,343,895
3 Pledges and grants receivable, net ......... 204,445 3 648,629
4 Accounts receivable, net ......... 4,255,808 4 11,000,954
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
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 ............. 6,816,237 7 10,765,618
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 839,480 9 762,874
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 37,389,331
b Less: accumulated depreciation. ..... 10b 13,830,231 24,312,861 10c 23,559,100
11 Investments—publicly traded securities .......... 427,248,935 11 534,791,104
12 Investments—other securities. See Part IV, line 11 ...... 89,198,849 12 100,442,658
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 828,607 15 2,880,991
16 Total assets. Add lines 1 through 15 (must equal line 34)... 570,136,185 16 700,195,823
Liabilities 17 Accounts payable and accrued expenses . 5,264,656 17 6,703,263
18 Grants payable ..........   18  
19 Deferred revenue .......... 2,779,659 19 3,125,829
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 411,446,644 21 488,139,251
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..... 22,211,185 25 25,251,760
26 Total liabilities. Add lines 17 through 25..... 441,702,144 26 523,220,103
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 128,434,041 27 154,394,102
28 Temporarily restricted net assets .....   28 16,685,296
29 Permanently restricted net assets .....   29 5,896,322
Organizations that do not follow SFAS 117, check here MediumBullet 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 ..... 128,434,041 33 176,975,720
34 Total liabilities and net assets/fund balances ..... 570,136,185 34 700,195,823
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
74,293,561
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
63,291,801
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
11,001,760
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
128,434,041
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
37,539,919
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
176,975,720
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow 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 HEALTH
 
Employer identification number

46-0422673
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(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?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
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).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
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.") . 343,647 895,894 1,400,471 5,772,674 13,930,641 22,343,327
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...... 24,624,300 26,077,880 34,777,947 40,864,118 56,880,853 183,225,098
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. 24,967,947 26,973,774 36,178,418 46,636,792 70,811,494 205,568,425
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
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. 18,356,276 17,820,549 18,814,556 17,719,931 18,116,948 90,828,260
c Add lines 7a and 7b.. 18,356,276 17,820,549 18,814,556 17,719,931 18,116,948 90,828,260
8 Public Support (Subtract line 7c from line 6.)           114,740,165
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... 24,967,947 26,973,774 36,178,418 46,636,792 70,811,494 205,568,425
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 1,897,477 2,357,097 2,775,837 3,905,961 1,831,569 12,767,941
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 1,897,477 2,357,097 2,775,837 3,905,961 1,831,569 12,767,941
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. 318,461 448,152 392,132 537,241 435,237 2,131,223
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.). 27,183,885 29,779,023 39,346,387 51,079,994 73,078,300 220,467,589
14
Section C. Computation of Public Support Percentage
15
15
52.040 %
16
16
42.330 %
Section D. Computation of Investment Income Percentage
17
17
5.790 %
18
18
8.350 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
AVERA HEALTH
 
Employer identification number

46-0422673
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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—
Special Rules
......................... 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)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
AVERA HEALTH
  		Employer identification number

46-0422673
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




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
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 II
Name of organization
AVERA HEALTH
  		Employer identification number

46-0422673
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 HEALTH
  		Employer identification number

46-0422673
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		 (c)
Use 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		 (c)
Use 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		 (c)
Use 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		 (c)
Use 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:  
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 HEALTH
 
Employer identification number

46-0422673
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
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.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
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

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
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(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? ......................................

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


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
No
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
58,899
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
10,487
j
Total. lines 1c through 1i ...................................
69,386
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
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”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
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).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
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
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: AVERA DAY AT THE SD LEGISLATURE
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 HEALTH
 
Employer identification number

46-0422673
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 .......    
5
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? ............
6
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. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
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)? ....................................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........ 8,535,863    
c Investment earnings or losses ... 2,080,865    
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		388,598    
f Administrative expenses ....      
g End of year balance ...... 10,228,130    
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet28.890 %
b
Permanent endowment: SchDMd Bullet57.650 %
c
Term endowment: SchDMd Bullet13.460 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, 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 .................   948,600 948,600
b Buildings ................   7,687,146 2,009,272 5,677,874
c Leasehold improvements ............        
d Equipment ................   28,711,085 11,820,959 16,890,126
e Other .................   42,500   42,500
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 23,559,100
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other 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) ACCOUNTS MANAGEMENT, INC. 		290,700 C

(B) AVERA COMMUNICATION, LLC 		210,255 C

(C) AVERA HEALTH PLANS, INC. 		8,752,297 C

(D) AVERA PROPERTY INSURANCE, LLC 		565,819 C

(E) PREMIER PURCHASING PARTNERS, L.P. 		1,372,082 C

(F) NPPC, LLC 		100,000 C

(G) NON-PUBLICLY TRADED HEDGE FUNDS 		59,617,619 F

(H) NON-PUBLICLY TRADED REAL ESTATE 		29,533,886 F

Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 100,442,658
Part VIII
Investments—Program 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.)Small Bullet  
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.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ESTIMATED INSURANCE CLAIMS PAYABLE 25,191,760
ANNUITIES PAYABLE 60,000







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 25,251,760
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

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 74,293,561
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 63,291,801
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 11,001,760
4 Net unrealized gains (losses) on investments .......................... 4 9,907,872
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 27,632,047
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 37,539,919
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 48,541,679
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 77,267,513
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 9,907,872
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 1,141,512
e Add lines 2a through 2d ..................... 2e 11,049,384
3 Subtract line 2e from line 1..................... 3 66,218,129
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 8,075,432
c Add lines 4a and 4b....................... 4c 8,075,432
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 74,293,561
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 62,376,559
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 510,478
e Add lines 2a through 2d...................... 2e 510,478
3 Subtract line 2e from line 1..................... 3 61,866,081
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 1,425,720
c Add lines 4a and 4b....................... 4c 1,425,720
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 63,291,801
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: AVERA HEALTH ADMINISTERS THE AVERA HEALTH POOLED INVESTMENT FUND, A FUND THAT IS MAINTAINED FOR THE BENEFIT OF FACILITIES THAT ARE SPONSORED, OPERATED, OR MANAGED BY AVERA HEALTH. INVESTMENTS ARE MADE IN CONFORMITY WITH THE OBJECTIVES AND GUIDELINES OF THE AVERA HEALTH POOLED INVESTMENT COMMITTEE. WITHIN THE FUND, PARTICIPATING FACILITIES SHARE IN A POOL OF INVESTMENTS THAT ARE MANAGED BY VARIOUS FUND MANAGERS. INVESTMENTS THAT ARE HELD FOR PARTICIPATING FACILITIES ARE RECORDED AS AVERA HEALTH POOLED INVESTMENTS WITH A CORRESPONDING LIABILITY ACCOUNT OF CUSTODIAL FUNDS - AVERA HEALTH POOLED INVESTMENTS ON THE BALANCE SHEET. AVERA HEALTH ALSO HOLDS ITS OWN INVESTMENTS WITHIN THE POOLED FUND AND RECORDS THEIR ALLOCATED SHARE OF INCOME AND LOSSES FROM THESE INVESTMENTS AS INVESTMENT INCOME IN THE FINANCIAL STATEMENTS.
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 65 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES RELATED TO HEALTH AND WELLNESS PROGRAMS IN AVERA AFFILIATED ORGANIZATIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE CORPORATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE CORPORATION'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   BOOK/TAX DIFFERENCE ON PARTNERSHIPS 115,820. TRANSFERS FROM AFFILIATES, NET 1,301,727. INSURANCE PROGRAM ADMIN INCOME NOT RECOGNIZED FOR TAX REPORTING 2,451,412. INITIAL CONTRIBUTION OF FOUNDATION NET ASSETS IN MERGER 26,769,341. EQUITY TRANSFERS FOR FOUNDATION PROJECTS AND OPERATING EXPENSES -3,777,696. FOUNDATION CHANGES IN UNRESTRICTED NET ASSETS 771,443.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   INSURANCE PROGRAM ADMIN INCOME NOT RECOGNIZED FOR TAX REPORTING 2,451,412. FOUNDATION EXPENSES REPORTED IN REVENUE ON FINANCIAL STATEMENTS -1,424,406. BOOK/TAX DIFFERENCE IN PARTNERSHIPS 114,506.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   INVESTMENT INCOME REPORTED IN FUND BALANCE ON FINANCIAL STATEMENTS 2,836,566. CONTRIBUTIONS REPORTED IN FUND BALANCE ON FINANCIAL STATEMENTS 5,749,344. SPECIAL EVENTS EXPENSES REPORTED IN REVENUE ON FORM 990 -510,478.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   SPECIAL EVENT EXPENSES REPORTED IN REVENUE ON FORM 990 510,478.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:   BOOK/TAX DIFFERENCE ON PARTNERSHIP EXPENSES 1,314. FOUNDATION EXPENSES REPORTED IN REVENUE ON FINANCIAL STATEMENTS 1,424,406.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AVERA HEALTH
 
Employer identification number

46-0422673
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. 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? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
CENTRAL AMERICA AND THE CARIBBEAN     INVESTMENTS    
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 0
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow 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 HEALTH
 
Employer identification number

46-0422673
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

RACE AGAINST BREAST CANCER
(event type) 		(b) Event #2

ROSES JUST BECAUSE
(event type) 		(c) Other Events

57
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 365,373 136,938 702,835 1,205,146
2 Less: Charitable
contributions . . . 		66,500   252,641 319,141
3 Gross income (line 1
minus line 2) . . . 		298,873 136,938 450,194 886,005
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 16     16
6 Rent/facility costs . . 8,777     8,777
7 Food and beverages . . 5,652     5,652
8 Entertainment . . . 753     753
9 Other direct expenses . 82,813 67,971 344,496 495,280
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 510,478
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 375,527
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
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 HEALTH
 
Employer identification number
46-0422673
Part I
General Information on Grants and Assistance
1
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? ....................................
2
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 (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) SOUTH DAKOTA STATE UNIVERSITY815 MEDARY AVE
BROOKINGS,SD57007 		46-0273801 501(C)(3) 1,540,000       CHARITABLE ASSISTANCE
(2) SDREIPO BOX 2282
SIOUX FALLS,SD571051505 		46-0442430 501(C)(3)   25,000 BOOK NOTE FORGIVENESS NOTE FORGIVENESS
(3) CATHOLIC FOUNDATION OF EASTERN SD523 NORTH DULUTH
SIOUX FALLS,SD57104 		46-6068924 501(C)(3) 96,152       CHARITABLE ASSISTANCE
(4) LIFELIGHT COMMUNICATIONS2601 S WESTERN AVE
SIOUX FALLS,SD57105 		46-0460742 501(C)(3) 35,000       CHARITABLE ASSISTANCE
(5) ON CALL ACCOUNT - SDSUBOX 2218A
BROOKINGS,SD57007 		46-6000364 SDSU 52,500       CHARITABLE ASSISTANCE
(6)  
 
  		          CHARITABLE ASSISTANCE
(7) SD AGRICULTURAL AND RURAL LEADERSHIPPO BOX 2170
BROOKINGS,SD57007 		36-4293293 501(C)(3) 10,000       CHARITABLE ASSISTANCE
(8) SD HIGH SCHOOL COACHES801 W EAGLE RIDGE ST
SIOUX FALLS,SD57108 		23-7297479 501(C)(3) 6,500       CHARITABLE ASSISTANCE
(9) SD JUNIOR GOLF FOUNDATION4809 WEST 41ST ST
SIOUX FALLS,SD57106 		46-0449824 501(C)(3) 12,500       CHARITABLE ASSISTANCE
(10) EDUCATION AND RESOURCE CENTER1900 S BILL DRIVE
SIOUX FALLS,SD57110 		20-1470473 501(C)(3) 131,250       CHARITABLE ASSISTANCE
(11) FORWARD SIOUX FALLSPO BOX 97
SIOUX FALLS,SD57101 		46-0396647   15,000       CHARITABLE ASSISTANCE
(12) SPECIAL OLYMPICS OF SD305 W 39TH ST
SIOUX FALLS,SD57105 		46-0359976 501(C)(3) 50,000       CHARITABLE ASSISTANCE
(13) THE FIRST TEE4809 WEST 41ST ST
SIOUX FALLS,SD57106 		46-0449824 501(C)(3) 25,000       CHARITABLE ASSISTANCE
(14) AMERICAN HEART ASSOCIATION208 LA SALLE ST SUITE 1500
CHICAGO,IL60604 		13-5613797 501(C)(3) 25,000       CHARITABLE ASSISTANCE
(15) MOUNTY MARTY COLLEGE1105 W 8TH STREET
YANKTON,SD57078 		46-0283336 501(C)(3) 50,000       CHARITABLE ASSISTANCE
(16) CATHOLIC FOUNDATION524 N DULUTH
SIOUX FALLS,SD57105 		46-6068925 501(C)(3) 6,000       CHARITABLE ASSISTANCE
(17) CATHOLIC FOUNDATION526 N DULUTH
SIOUX FALLS,SD57107 		46-6068927 501(C)(3) 95,000       CHARITABLE ASSISTANCE
(18) MARCH OF DIMES1000 N WEST 41 ST STE 104
SIOUX FALLS,SD57104 		13-1846366 501(C)(3) 26,000       CHARITABLE ASSISTANCE
(19) YMCA WORTHINGTON1501 COLLEGEWAY
WORTHINGTON,MN56187 		41-6007569 501(C)(3) 6,110       BUILDING PROJECT
(20) AVERA DELL RAPIDS AREA HEALTH CENTER909 N IOWA AVE
DELLRAPIDS,SD57022 		46-0270655 501(C)(3) 24,304       EQUIPMENT AND PROGRAMS
(21) AVERA GREGORY HEALTHCARE CENTER400 PARK AVE
GREGORY,SD57533 		30-0189987 501(C)(3) 5,563       EQUIPMENT AND PROGRAMS
(22) LANDMANN-JUNGMAN MEMORIAL HOSPITAL600 BILLARS ST
SCOTLAND,SD57059 		46-6015787 501(C)(3) 100,380       EQUIPMENT AND PROGRAMS
(23) MARSHALL COUNTY HEALTHCARE CENTER413 9TH ST
BRITTON,SD57430 		46-0380552 501(C)(3) 10,874       EQUIPMENT AND PROGRAMS
(24) SIOUX CENTER COMMUNITY HOSPITAL AND HEALTH CENTER605 S MAIN AVE
SIOUX CENTER,IA51250 		42-0796764 501(C)(3) 59,941       EQUIPMENT AND PROGRAMS
(25) TYLER HEALTHCARE CENTER240 WILLOW ST
TYLER,MN56178 		41-0853163 501(C)(3) 73,384       EQUIPMENT AND PROGRAMS
(26) UNITED RETIREMENT CENTER405 1ST AVE
BROOKINGS,SD57006 		46-0271768 501(C)(3) 273,746       EQUIPMENT AND PROGRAMS
(27) PIPESTONE COUNTY MEDICAL CENTER916 4TH AVE SW
PIPESTONE,MN56164 		41-1392082 501(C)(3) 15,463       EQUIPMENT AND PROGRAMS
(28) HAITIAN HEALTH FOUNDATION97 SHERMAN ST
NORWICH,CT06360 		06-1135999 501(C)(3) 10,453       EARTHQUAKE RELIEF/GENERAL ASSISTANCE
(29) WAGNER COMMUNITY MEMORIAL HOSPITAL513 THIRD STREET SW
WAGNER,SD57380 		46-0226283 501(C)(3) 203,700       EQUIPMENT AND PROGRAMS
(30) FLOYD VALLEY HOSPITAL714 LINCOLN STREET NE
LEMARS,IA51031 		20-4095776 501(C)(3) 107,938       EQUIPMENT AND PROGRAMS
(31) AVERA HAND COUNTY MEMORIAL HOSPITAL300 W 5TH ST
MILLER,SD57362 		46-0356287 501(C)(3) 55,000       CHARITABLE ASSISTANCE
(32) AVERA QUEEN OF PEACE HOSPITAL525 N FOSTER
MITCHELL,SD57301 		46-0224604 501(C)(3) 100,654       EQUIPMENT AND PROGRAMS
(33) AVERA ST LUKE'S HOSPITAL305 S STATE ST
ABERDEEN,SD57401 		46-0224598 501(C)(3) 401,607       EQUIPMENT AND PROGRAMS
(34) AVERA HOLY FAMILY826 N EIGHTH ST
ESTHERVILLE,IA51334 		42-0680370 501(C)(3) 19,084       EQUIPMENT AND PROGRAMS
(35) AVERA MCKENNAN800 E 21ST ST
SIOUX FALLS,SD57105 		46-0224743 501(C)(3) 1,361,003       EQUIPMENT AND PROGRAMS
(36) AVERA MARSHALL300 S BRUCE STREET
MARSHALL,MN56258 		41-0919153 501(C)(3) 26,145       EQUIPMENT AND PROGRAMS
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
36
3
Enter total number of other organizations ................................ . Bullet Image
1
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

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		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) HAITI SCHOLARSHIPS 18 20,700      
(2) OUT OF POCKET MEDICAL ASSISTANCE 61 72,964      
(3) HEALTH INSURANCE PREMIUM ASSISTANCE 475 252,792      
(4) FOOD, RENT, CLOTHING, UTILITIES, LIVING EXPENSES 194 48,559      
(5) MEDICAL BILLS 428 214,299      
(6) SCHOLARSHIPS AND TRAINING 170 89,715      
(7) TRANSPORTATION COSTS 75 4,414      
(8) CANCER PATIENT ASSISTANCE/FITNESS/WIGS/ETC 90 21,214      
(9) CHILD CARE 10 1,704      
(10) GENERAL ASSISTANCE 28 5,784      

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: THE ORGANIZATION MAKES GRANTS TO OTHER ORGANIZATIONS EXEMPT UNDER 501(C)(3) TO ENSURE THE FUNDS WILL BE USED FOR CHARITABLE PURPOSES. DURING THE YEAR ENDING JUNE 30, 2011, THE ORGANIZATION MADE CONTRIBUTIONS TO OTHER NON-PUBLIC CHARITIES AND GOVERNMENTAL TYPE ENTITIES IN FURTHERANCE OF COMMUNITY DEVELOPMENT. THE CONTRIBUTIONS ARE APPROVED BY THE BOARD FOR THIS PURPOSE. SCHOLARSHIP FUNDS HAVE DIFFERENT SETS OF CRITERIA FOR DETERMINING ELIGIBILITY AND WINNERS. ASSISTANCE TO INDIVIDUALS IS DETERMINED WITH ASSISTANCE FROM EACH HOSPITAL'S SOCIAL SERVICES DEPARTMENT OR WITHIN A COMMITTEE AT THE HOSPITAL.
Schedule I (Form 990) 2010


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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 HEALTH
 
Employer identification number

46-0422673
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
Yes
 
2
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? ....
2
Yes
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) DR KIM W JUNDT (i)
(ii)		 0
304,332 		0
50,571 		0
90,239 		0
12,250 		0
16,105 		0
473,497 		0
0
(2) JOHN PORTER (i)
(ii)		 1,254,485
0 		0
0 		18,691
0 		12,250
0 		18,133
0 		1,303,559
0 		0
0
(3) JAMES BRECKENRIDGE (i)
(ii)		 604,387
0 		0
0 		9,662
0 		12,250
0 		8,597
0 		634,896
0 		0
0
(4) FREDRICK SLUNECKA (i)
(ii)		 927,393
0 		0
0 		14,407
0 		12,250
0 		16,488
0 		970,538
0 		0
0
(5) DAVID ERICKSON (i)
(ii)		 508,447
0 		0
0 		11,196
0 		12,250
0 		17,084
0 		548,977
0 		0
0
(6) RON JACOBSON (i)
(ii)		 522,240
0 		0
0 		10,853
0 		12,250
0 		16,141
0 		561,484
0 		0
0
(7) PAM REZAC (i)
(ii)		 457,910
0 		0
0 		11,769
0 		12,250
0 		18,885
0 		500,814
0 		0
0
(8) JEAN REED (i)
(ii)		 452,949
0 		0
0 		12,917
0 		12,250
0 		18,523
0 		496,639
0 		0
0
(9) THOMAS RASMUSSEN (i)
(ii)		 449,516
0 		0
0 		13,674
0 		12,250
0 		19,998
0 		495,438
0 		0
0







Schedule J (Form 990) 2010

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
  PART I, LINE 1A ALL SENIOR EXECUTIVES ARE ELIGIBLE FOR $2,500 PER YEAR TO PAY FOR SOCIAL CLUB DUES. IF AN EMPLOYEE CHOOSES TO TAKE ADVANTAGE OF THIS BENEFIT, THE AMOUNT IS INCLUDED IN THEIR TAXABLE INCOME. THOSE PAID: JAMES BRECKENRIDGE, JOHN PORTER, JEAN REED, AND FRED SLUNECKA.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
AVERA HEALTH
 
Employer identification number
46-0422673
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
  		46-0315509 83755VNB6 06-18-2008 189,222,932 AVERA HEALTH SERIES 2008A REFUNDED SERIES 1994, 2000, BRIDGE LOAN   X   X   X
B SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
  		46-0315509 83755VNH3 07-01-2008 61,495,000 AVERA HEALTH SERIES 2008C REFUNDED 2006 SERIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 189,222,932 61,495,000    
4 Gross proceeds in reserve funds . . 110      
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 1,272,562 388,831    
8 Credit enhancement from proceeds. 282,213 31,169    
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 91,009,361      
11 Other spent proceeds . . 96,658,796 61,075,000    
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2010 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X          
15 Were the bonds issued as part of an advance refunding issue?   X   X        
16 Has the final allocation of proceeds been made? . .   X X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X     X        
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X          
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X        
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .   X   X        
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 1.200 % 0.200 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0.100 % 0 %    
6 Total of lines 4 and 5 . . .. . . . . . 1.300 % 0.200 %    
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?   X   X        
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue? X   X          
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue? X   X          
b Name of provider . BANK OF
AMERICA/MERRILL 		BANK OF
AMERICA/MERRILL 		 
  		 
 
c Term of hedge . . 24.100000000000 25.000000000000    
d Was the hedge superintegrated? .   X   X        
e Was a hedge terminated? .   X X          
4a Were gross proceeds invested in a GIC? .   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X        
6 Did the bond issue qualify for an exception to rebate? . . .   X   X        
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AVERA HEALTH
 
Employer identification number

46-0422673
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?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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
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 (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) LINDA BRECKENRIDGE SPOUSE OF OFFICER 111,119 EMPLOYEE COMPENSATION   No
(2) SDN COMMUNICATIONS DIRECTOR OF THE BOARD IS CEO OF SDN COMMUNICATIONS 868,000 VOICE DATA AND VIDEO SERVICES   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:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AVERA HEALTH
 
Employer identification number

46-0422673
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles .. X 1    
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 14 603,295 AVG OF HIGH/LOW
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
1
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
NON REPORTING OF REVENUE: PART I, LINE 33: THE ONLY AMOUNTS INCLUDED IN REVENUE FOR THE FINANCIAL STATEMENT REPORTING ARE NON-CASH CONTRIBUTIONS OF STOCK SECURITIES. NON-CASH CONTRIBUTIONS NOT INCLUDED FOR FINANCIAL STATEMENTS INCLUDE ITEMS FOR THE BENEFIT OF THE AVERA FACILITIES WHICH INCLUDE SUCH THINGS AS DRUGS, MEDICAL SUPPLIES, AND SPECIAL EVENT DONATIONS. THE ORGANIZATION DID NOT RECORD A VEHICLE DONATED DURING THE FISCAL YEAR AS THE ITEM WAS NOT SOLD. HOWEVER, ALL APPROPRIATE TAX FILINGS WERE COMPLETED FOR THE DONOR OF THE DONATED VEHICLE.
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
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 HEALTH
 
Employer identification number

46-0422673
Identifier Return Reference Explanation
NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 AS OF JULY 1, 2010, THE ACTIVITIES OF AVERA HEALTH FOUNDATION BECAME A PART OF AVERA HEALTH.
FORM 990, PART VI, SECTION A, LINE 6   THE ORGANIZATION HAS TWO CLASSES OF MEMBERS: SPONSORSHIP MEMBERS AND SYSTEM MEMBERS. SPONSORSHIP MEMBERS SHALL CONSIST COLLECTIVELY OF (I) THOSE PERSONS SERVING FROM TIME TO TIME AS THE PRESIDENT AND COUNCIL OF THE PRESENTATION SISTERS OF THE BLESSED VIRGIN MARY OF ABERDEEN, SOUTH DAKOTA AND (II) THOSE PERSONS SERVING FROM TIME TO TIME AS THE PRIORESS AND COUNCIL OF THE BENEDCITINE CONVENT OF THE SACRED HEART (YANKTON, S.D.) SYSTEM MEMBERS SHALL CONSIST OF SIX SISTERS- THREE PRESENTATION SISTERS APPOINTED BY THE PRESENTATION SPONSORSHIP MEMBERS AND THREE BENEDICTINE SISTERS APPOINTED BY THE BENEDICTINE SPONSORSHIP MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A   THE SYSTEM MEMBERS HAVE THE POWER TO APPOINT THE BOARD OF DIRECTORS OF AVERA HEALTH AND TO SUSPEND OR REMOVE A DIRECTOR AT ANY TIME, WITH OR WITHOUT CAUSE. THEY ALSO HAVE THE POWER TO APPOINT BENEDICTINE OR PRESENTATION SISTERS TO THE BOARDS OF DIRECTORS OF ANY SPONSORED WORK OR MINISTRY OF AVERA HEALTH.
FORM 990, PART VI, SECTION A, LINE 7B   THE FOLLOWING POWERS SHALL BE RESERVED TO AND EXERCISED EXCLUSIVELY BY THE SPONSORSHIP MEMBERS AND NONE OF THE FOLLOWING ACTIONS SHALL BE TAKEN BY AVERA HEALTH WITHOUT ACTION OF THE SPONSORSHIP MEMBERS: (A) TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE STATEMENTS OF PHILOSOPHY, MISSION, GUIDING PRINCIPLES AND VALUES OF AVERA HEALTH; (B) TO INITIATE THE ADOPTION, AMENDMENT OR REPEAL OF ANY PROVISION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF AVERA HEALTH, AND TO GIVE FINAL APPROVAL OF ANY SUCH ACTION WITH RESPECT THERETO; (C) TO ESTABLISH POLICIES REGARDING THE ALIENATION OF REAL PROPERTY AND PRECIOUS ARTIFACTS ASSOCIATED WITH THE HEALTHCARE MINISTRY WHICH ARE UNDER THE CANONICAL STEWARDSHIP OF THE PRESENTATION SISTERS OR THE BENEDICTINE SISTERS; (D) TO APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF AVERA HEALTH, OR THE DIVESTITURE OF ANY SPONSORED WORK OR MINISTRY ASSOCIATED WITH AVERA HEALTH; (E) TO CHANGE THE COMPOSITION OF THE SPONSORSHIP MEMBERS, INCLUDING THE ADDITION OF OTHER INDIVIDUALS, PARTIES OR ENTITIES TO BE SPONSORSHIP MEMBERS; AND (F) TO APPROVE THE CREATION OF NEW SPONSORED WORKS OR MINISTRIES TO BE CONDUCTED BY OR UNDER THE AUTHORITY OF AVERA HEALTH. THE FOLLOWING POWERS SHALL BE RESERVED TO AND EXERCISED EXCLUSIVELY BY THE SYSTEM MEMBERS AND NONE OF THE FOLLOWING ACTIONS SHALL BE TAKEN BY AVERA HEALTH WITHOUT ACTION OF THE SYSTEM MEMBERS: (A) TO APPOINT THE BOARD OF DIRECTORS OF AVERA HEALTH AND TO SUSPEND OR REMOVE A DIRECTOR AT ANY TIME, WITH OR WITHOUT CAUSE; (B) TO APPOINT BENEDICTINE OR PRESENTATION SISTERS TO THE BOARDS OF DIRECTORS OF ANY SPONSORED WORK OR MINISTRY OF AVERA HEALTH; (C) TO APPOINT THE CHAIR AND VICE CHAIR OF THE BOARD OF DIRECTORS; (D) TO APPOINT, EVALUATE, SUSPEND OR REMOVE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER; (E) TO REVIEW AND APPROVE THE OPERATING AND CAPITAL BUDGETS, INCLUDING EXPENDITURES OUTSIDE OF BUDGET, AND THE STRATEGIC PLAN, OF AVERA HEALTH; (F) TO ADOPT PROCEDURES FOR ASSURING THAT CORPORATE ACTIONS ARE CONSISTENT WITH THE PHILOSOPHY, MISSION, GUIDING PRINCIPLES AND VALUES OF AVERA HEALTH; (G) TO PROVIDE RECOMMENDATIONS TO THE SPONSORSHIP MEMBERS ON MATTERS REQUIRING SPONSORSHIP MEMBERS' APPROVAL OR ACTION; (H) TO ADOPT POLICIES DESIGNED TO EFFECTUATE THE POWERS RESERVED TO THE SYSTEM MEMBERS; AND (I) TO EXERCISE OVERSIGHT OF THE GUIDING PRINCIPLES AND SUCH AUTHORITIES WHICH MAY BE ASSIGNED OR DELEGATED BY THE SPONSORSHIP MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11   THE FORM 990 IS REVIEWED BY THE CEO AND CFO. AFTER INITIAL REVIEWS, THE RETURN IS PROVIDED TO THE BOARD PRIOR TO FILING.
  FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES. AT EACH BOARD MEETING, A REQUEST IS MADE FOR ALL BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST PERTAINING TO ANY ITEM LISTED ON THE AGENDA OR PERTAINING TO ANY POTENTIAL ITEM THAT COULD BE DISCUSSED DURING THE COURSE OF THE MEETING. THE DECLARATION OF CONFLICT OF INTEREST IS RECORDED IN THE MEETING MINUTES. THE BOARD MAKES A DETERMINATION OF WHETHER THERE IS A CONFLICT OF INTEREST AND IF SO, IMPLEMENTS THE PROCEDURE FOR EVALUATING THE ISSUE OR TRANSACTION INVOLVED. THE BOARD MEMBER OR OFFICER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND DIRECTORS. THE INFORMATION IS MAINTAINED IN A DATABASE AND A REPORT IS PROVIDED TO THE BOARD.
  FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY THE COMPENSATION COMMITTEE OF AVERA HEALTH, WHICH IS COMPRISED OF SIX (6) SYSTEM MEMBERS APPOINTED BY THE RELIGIOUS ORDERS, MEETS WITH AN INDEPENDENT CONSULTANT REGARDING FAIR MARKET VALUE FOR COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE APPROVES ALL SALARIES BASED ON COMPARABLE DATA AND DOCUMENTS THE BASIS FOR THEIR DECISION IN MEETING MINUTES.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC.
  FORM 990, PART VII, SECTION A: THE FOLLOWING INDIVIDUALS DEDICATED A MINIMUM OF 40 HOURS PER WEEK TO RELATED ORGANIZATIONS. DR. KIM JUNDT - AVERA ST. LUKE'S RON JACOBSON - AVERA ST. LUKE'S PAM REZAC - SACRED HEART HEALTH SERVICES TOM RASMUSSEN - AVERA QUEEN OF PEACE HOSPITAL THE FOLLOWING INDIVIDUALS PROVIDE THE INDICATED HOURS PER WEEK TO VARIOUS RELATED ORGANIZATIONS: SISTER BARBARA MCTAGUE - AVERA WORKERS' COMPENSATION TRUST (1) SISTER KATHLEEN CROWLEY - AVERA HOLY FAMILY (1), AVERA QUEEN OF PEACE HOSPITAL (2.5), AVERA WORKERS' COMPENSATION TRUST (1) SISTER LUCILLE WELBIG - AVERA WORKERS' COMPENSATION TRUST (1), SACRED HEART HEALTH SERVICES (2) SISTER MARY JAEGER - AVERA ST. ANTHONY'S HOSPITAL (1), ST. BENEDICT HEALTH CENTER (2), AVERA WORKERS' COMPENSATION TRUST (1) SISTER DEBRA KOLECKA - AVERA WORKERS' COMPENSATION TRUST (1) SISTER MARY THOMAS - AVERA WORKERS' COMPENSATION TRUST (1)
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 9,907,872. BOOK/TAX DIFFERENCE ON PARTNERSHIPS 115,820. TRANSFERS FROM AFFILIATES, NET 1,301,727. INSURANCE PROGRAM ADMIN INCOME NOT RECOGNIZED FOR TAX REPORTING 2,451,412. INITIAL CONTRIBUTION OF FOUNDATION NET ASSETS IN MERGER 26,769,341. EQUITY TRANSFERS FOR FOUNDATION PROJECTS AND OPERATING EXPENSES -3,777,696. FOUNDATION CHANGES IN UNRESTRICTED NET ASSETS 771,443. TOTAL TO FORM 990, PART XI, LINE 5: 37,539,919.
  SCHEDULE K, PART VI PART I, LINE A, COLUMN (F): THE 2008 A/B BONDS REFUNDED SERIES 1994 (ISSUED 01-12-95) AND SERIES 2000 (ISSUED 03-01-2000). IT ALSO FUNDED A PROJECT. PART I, LINE B, COLUMN (F): THE 2008 C BONDS REFUNDED SERIES 2004 (ISSUED 05-18-2004). PART IV, LINE 3C, COLUMN A: THE SWAP WAS INITIATED IN THE 2004 BOND ISSUE AND STARTED MAY 18, 2004 AND IS SCHEDULED TO TERMINATE JULY 1, 2028. PART IV, LINE 3C, COLUMN B: THE HEDGE WAS NO LONGER INTEGRATED WITH THE BOND ISSUE AFTER 12-9-10 AND THEREFORE ONLY IN PLACE A PORTION OF THE YEAR. AVERA HEALTH IS NOT DISCLOSING TAX EXEMPT BONDS ON PART X, LINE 20. THE BONDS WERE ISSUED TO AVERA HEALTH ON BEHALF OF THE AVERA OBLIGATED GROUP. THE AVERA OBLIGATED GROUP CONSISTS OF AVERA MCKENNAN, AVERA ST. LUKE'S, AVERA QUEEN OF PEACE, 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.
  FORM 8621, PART IV AVERA HEALTH IS FILING FORM 8621 AS A SHAREHOLDER IN VARIOUS FOREIGN FUNDS AS THEY ARE CONSIDERED TO BE PASSIVE FOREIGN INVESTMENT COMPANIES. THE DISTRIBUTIONS FROM THESE FUNDS TO AVERA HEALTH ARE NOT TAXABLE AND THEREFORE NOT INCLUDED ON PART IV OF FORM 8621. THE FUNDS ARE IDENTIFIED BELOW: SHEPHERD INVESTMENTS INTERNATIONAL, LTD. THE CANYON VALUE REALIZATION FUND SCP OCEAN FUND, LTD.
  FORM 990, PART VI QUESTION 16B: THERE IS NO WRITTEN POLICY OR PROCEDURE. IN THE EVENT OF ANY SUCH PROPOSED TRANSACTION, THE BOARD OR A COMMITTEE WITH DELEGATED AUTHORITY REVIEWS ALL MATERIALS, VALUATIONS AND OPERATIONAL ASPECTS FOR ANY PROPOSED TRANSACTION. SUCH TRANSACTION WOULD BE EVALUATED IN ACCORDANCE WITH THE EXEMPT STATUS OF THE ORGANIZATION AND ITS APPLICABLE PURPOSES. ANY TRANSACTION ALSO WOULD BE APPROVED BY THE BOARD AND THE MEMBER.
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:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
AVERA HEALTH
 
Employer identification number

46-0422673
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







(1) AVERA COMMUNICATION LLC
3900 WEST AVERA DRIVE SUITE 300
SIOUX FALLS,SD571085434
46-0453770 		TELECOMMUNICATIONS SD 1,210,997 298,215 N/A










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
Yes No
(1) AVERA ST ANTHONY'S HOSPITAL

300 N 2ND STREET

ONEILL,NE68763
47-0463911 		HEALTHCARE SERVICES NE 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(2) AVERA HOLY FAMILY

826 NORTH 8TH STREET

ESTHERVILLE,IA51334
42-0680370 		HEALTHCARE SERVICES IA 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(3) AVERA HOLY FAMILY FOUNDATION

826 NORTH 8TH STREET

ESTHERVILLE,IA51334
42-1317452 		SUPPORT OF HOLY FAMILY HOSPITAL AND HOME HEALTH AGENCY IA 501(C)(3) LINE 9 AVERA HOLY FAMILY
 
 
No
(4) ST BENEDICT HEALTH CENTER

401 WEST GLYNN DRIVE

PARKSTON,SD57366
46-0226738 		HEALTHCARE SERVICES SD 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(5) 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
(6) AVERA MCKENNAN

1325 S CLIFF AVE PO BOX 5045

SIOUX FALLS,SD57117
46-0224743 		HEALTHCARE SERVICES SD 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(7) AVERA QUEEN OF PEACE HOSPITAL

525 NORTH FOSTER

MITCHELL,SD57301
46-0224604 		HEALTHCARE SERVICES SD 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(8) SACRED HEART HEALTH SERVICES

501 SUMMIT STREET

YANKTON,SD57078
46-0225483 		HEALTHCARE SERVICES SD 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(9) 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
(10) 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
(11) 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
(12) AVERA ST LUKE'S

305 SOUTH STATE STREET

ABERDEEN,SD57401
46-0224598 		HEALTHCARE SERVICES SD 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(13) AVERA WORKERS' COMPENSATION TRUST

3900 WEST AVERA DRIVE

SIOUX FALLS,SD57108
46-0407148 		ECONOMICAL COVERAGE OF WORKERS' COMPENSATION CLAIMS SD 501(C)(3) LINE 11B, II AVERA HEALTH
 
Yes
 
(14) AVERA MARSHALL

300 S BRUCE STREET

MARSHALL,MN56258
41-0919153 		HEALTHCARE SERVICES MN 501(C)(3) LINE 3 AVERA HEALTH
 
Yes
 
(15) AVERA MARSHALL FOUNDATION

300 S BRUCE STREET

MARSHALL,MN56258
41-1784801 		FUNDRAISING MN 501(C)(3) LINE 7 AVERA MARSHALL
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
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 V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) 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
                  
(2) MIDWEST REGIONAL IMAGING SERVICES LLC

1325 S CLIFF AVE PO BOX 5045
SIOUX FALLS,SD57117
47-0874983 		HEALTH CARE - MEDICAL IMAGING SD N/A
                  
(3) MERSCO MEDICAL OF PIERRE LLC

329 E DAKOTA
PIERRE,SD57501
46-0444002 		MEDICAL SERVICES - HOME MEDICAL EQUIPMENT SD N/A
                  
(4) 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
                  
(5) AVERA HOME MEDICAL EQUIPMENT OF ESTHERVILLE LLC

PO BOX 5045
SIOUX FALLS,IA57117
20-1686097 		MEDICAL SERVICES - HOME MEDICAL EQUIPMENT SD N/A
                  
(6) 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
                  
(7) AVERA HOME MEDICAL EQUIPMENT OF MARSHALL LLC

1104 EAST COLLEGE DRIVE
MARSHALL,MN56258
20-5271924 		MEDICAL SERVICES - HOME MEDICAL EQUIPMENT SD N/A
                  
(8) Q&M PROPERTIES LLC

525 NORTH FOSTER
MITCHELL,SD57301
73-1652049 		MEDICAL CLINIC BUILDING SD N/A
                  
(9) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC

310 S PENN
ABERDEEN,SD57401
46-0461429 		SURGICAL ASSOCIATES SD N/A
                  
(10) 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
                  
(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)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) ACCOUNTS MANAGEMENT INC
5132 S CLIFF AVE SUITE 101
SIOUX FALLS,SD57108
46-0373021 		COLLECTION AGENCY SD N/A
 C 1,482,944 1,448,019 75.000 %
(2) AVERA HEALTH PLANS INC
3900 WEST AVERA DRIVE SUITE 101
SIOUX FALLS,SD57108
46-0451539 		HEALTH FINANCING AND HEALTH PLAN ADMIN SD N/A
 C 74,350,791 22,247,023 100.000 %
(3) AVERA PROPERTY INSURANCE INC
610 W 23RD ST PO BOX 38
YANKTON,SD57078
46-0463155 		INSURANCE SD N/A
 C 594,811 1,207,974 100.000 %
(4) VALLEY HEALTH SERVICES
501 SUMMIT STREET
YANKTON,SD57078
46-0357149 		MEDICAL EQUIPMENT SD N/A
 C      






Schedule R (Form 990) 2010
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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
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) AVERA MARSHALL

 D 205,797 CHANGE IN NOTE RECEIVABLE
(2) AVERA MCKENNAN

 D 204,407 CHANGE IN NOTE RECEIVABLE
(3) AVERA MCKENNAN

 K 20,346,012 GENERAL LEDGER
(4) AVERA QUEEN OF PEACE HOSPITAL

 K 3,575,868 GENERAL LEDGER
(5) AVERA ST LUKE'S

 K 4,680,492 GENERAL LEDGER
(6) SACRED HEART HEALTH SERVICES

 K 4,321,316 GENERAL LEDGER
(7) AVERA MARSHALL

 K 1,568,868 GENERAL LEDGER
(8) AVERA WORKER'S COMPENSATION TRUST

 K 655,000 GENERAL LEDGER
(9) AVERA MARSHALL

 P 80,094 REPORT FROM ACCOUNTING SYSTEM
(10) AVERA MCKENNAN

 P 19,465,870 REPORT FROM ACCOUNTING SYSTEM
(11) AVERA QUEEN OF PEACE HOSPITAL

 P 3,260,979 REPORT FROM ACCOUNTING SYSTEM
(12) SACRED HEART HEALTH SERVICES

 P 3,606,163 REPORT FROM ACCOUNTING SYSTEM
(13) AVERA ST LUKE'S

 P 3,372,622 REPORT FROM ACCOUNTING SYSTEM
(14) AVERA HEALTH PLANS INC

 P 160,693 REPORT FROM ACCOUNTING SYSTEM
(15) ST BENEDICT HEALTH CENTER

 P 101,299 REPORT FROM ACCOUNTING SYSTEM
(16) AVERA MCKENNAN

 O 2,491,543 VENDOR LISTING OF PAYMENTS
(17) AVERA QUEEN OF PEACE HOSPITAL

 O 164,412 VENDOR LISTING OF PAYMENTS
(18) SACRED HEART HEALTH SERVICES

 O 147,555 VENDOR LISTING OF PAYMENTS
(19) AVERA ST LUKE'S

 O 258,086 VENDOR LISTING OF PAYMENTS
(20) AVERA WORKER'S COMPENSATION TRUST

 O 117,378 VENDOR LISTING OF PAYMENTS
(21) AVERA HOLY FAMILY

 P 58,707 REPORT FROM ACCOUNTING SYSTEM
Schedule R (Form 990) 2010
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 V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
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: