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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC 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
noncash assistance
(h) Purpose of grant
or assistance
(1) Aberdeen Catholic School System
1400 N Dakota St
Aberdeen,SD57401
46-0336005 501c3 89,500       Sponsorship
(2) Aberdeen Christian School
1500 Hwy 281 N
Aberdeen,SD57401
91-1806433 501c3 10,500       Sponsorship
(3) Aberdeen Ride Line
205 N 4th St
Aberdeen,SD57401
46-6000010 501c3 15,000       Sponsorship
(4) ALS Association - MNNDSD Chapter
333 N Washington Ave Ste 105
Minneapolis,MN55401
41-1756085 501c3 15,000       Sponsorship
(5) American Cancer Society
250 Williams St
Atlanta,GA30303
13-1788491 501c3 37,900       Sponsorship
(6) American Cancer Society Cancer Action Network
555 11th St NW Ste 300
Washington,DC20004
52-2340031 501c4 8,500       Sponsorship
(7) American Heart Association - Midwest Affiliate
PO Box 50035
Prescott,AZ86304
13-5613797 501c3 25,000       Sponsorship
(8) American Red Cross of Eastern SD
808 West Ave North
Sioux Falls,SD57104
53-0196605 501c3 10,000       Sponsorship
(9) Boys & Girls Club of Aberdeen Area
1121 1st Ave SE
Aberdeen,SD57401
23-7062273 501c3 60,000       Sponsorship
(10) Boys & Girls Club of the Sioux Empire
824 E 14th St
Sioux Falls,SD57104
46-0399482 501c3 10,000       Sponsorship
(11) Brandon Valley Baseball Association
PO Box 605
Brandon,SD57005
46-0401362 501c3 10,000       Sponsorship
(12) Brandon Valley Booster Club
PO Box 572
Brandon,SD57005
46-0393971 501c3 6,500       Sponsorship
(13) Brookings Health System
300 22nd Ave
Brookings,SD57006
46-6000069 City of Brookings 30,500       Sponsorship
(14) Brookings School District
2130 8th St S
Brookings,SD57006
46-6000834 City of Brookings 36,050       Sponsorship
(15) Canton School District 41-1
800 N Main St
Canton,SD57013
46-6002143 City of Canton 10,000       Sponsorship
(16) Sioux Falls School District 49-5 (CTE Academy)
4700 W Career Cir
Sioux Falls,SD57107
46-6002586 City of Sioux Falls 12,500       Sponsorship
(17) Catholic Community Foundation for Eastern SD
523 N Duluth Ave
Sioux Falls,SD57104
46-6000424 501c3 100,000       Sponsorship
(18) Charis Ministry Partners
1300 E 10th St
Sioux Falls,SD57103
38-3775128 501c3 7,000       Sponsorship
(19) Children's Home Society of South Dakota Foundation
PO Box 1749
Sioux Falls,SD57101
46-0224542 501c3 12,000       Sponsorship
(20) Citizens Involvement Council
2520 E Franklin
Pierre,SD57501
46-0317107 501c3 10,000       Sponsorship
(21) City of Mitchell
612 N Main St
Mitchell,SD57301
46-6000305 City of Mitchell 15,000       Sponsorship
(22) Compass Center
1704 S Cleveland Ave Ste 3
Sioux Falls,SD57103
46-0350199 501c3 5,500       Sponsorship
(23) Dakota Resources
25795 475th Ave Ste 1
Renner,SD57055
46-0442430 501c3 35,000       Sponsorship
(24) Dakota Wesleyan University
1200 W University Ave
Mitchell,SD57301
46-0224589 501c3 34,500       Sponsorship
(25) DakotAbilities
1116 S 4th Ave
Sioux Falls,SD57105
46-0306216 501c3 13,000       Sponsorship
(26) Daktronics Inc
PO Box 86
Minneapolis,MN55486
46-0306862   11,250       Community Development
(27) Delta Dental of South Dakota Foundation
804 N Euclid Ave Ste 101
Pierre,SD57501
91-1776857 501c3 20,000       Sponsorship
(28) Destiny Healthcare International
1417 S Minnesota Ave
Sioux Falls,SD57105
51-0529480 501c3 15,000       Sponsorship
(29) Dow Rummel Village
1321 W Dow Rummel St
Sioux Falls,SD57104
46-0271277 501c3 25,000       Sponsorship
(30) Downtown Sioux Falls Inc
230 S Phillips Ave Ste 102
Sioux Falls,SD57104
36-3627217 501c4 21,000       Sponsorship
(31) EmBe
300 W 11th St
Sioux Falls,SD57104
46-0234998 501c3 31,500       Sponsorship
(32) Etc for Her
1112 S Holly Dr
Sioux Falls,SD57105
26-3803061   19,000       Sponsorship
(33) Family Visitation Center
311 E 14th St
Sioux Falls,SD57104
26-3654937 501c3 18,500       Sponsorship
(34) Feeding South Dakota
4701 N Westport Ave
Sioux Falls,SD57107
36-3293534 501c3 25,100       Sponsorship
(35) Fellowship of Christian Athletes
8701 Leeds Road
Kansas City,MO64129
44-0610626 501c3 20,000       Sponsorship
(36) Forward Sioux Falls
PO Box 907
Sioux Falls,SD57101
46-0396647   150,000       Sponsorship
(37) Furniture Mission of South Dakota
209 N Nesmith Ave
Sioux Falls,SD57103
81-0584450 501c3 9,000       Sponsorship
(38) Glacial Lakes Area Development
PO Box 231
Britton,SD57430
87-0787080 501c3 10,000       Sponsorship
(39) Governor's Office of Economic Development
711 E Wells Ave
Pierre,SD57501
46-6000364 State of SD 16,000       Sponsorship
(40) Ground Works
201 N Weber Ave Ste 201
Sioux Falls,SD57103
47-5498537 501c3 6,000       Sponsorship
(41) Habitat for Humanity of the Brookings Area
PO Box 412
Brookings,SD57006
46-0437158 501c3 15,000       Sponsorship
(42) Harrisburg Baseball Association
PO Box 434
Harrisburg,SD57032
27-0606157 501c3 18,000       Sponsorship
(43) Harrisburg School District
PO Box 187
Harrisburg,SD57032
46-6002218 City of Harrisburg 27,000       Sponsorship
(44) Helpline Center Inc
1000 N West Ave Ste 310
Sioux Falls,SD57104
23-7424387 501c3 15,000       Sponsorship
(45) Holy Redeemer Catholic Church
503 W Lyon St
Marshall,MN56258
41-0718327 501c3 50,000       Sponsorship
(46) Junior Achievement of South Dakota
1000 N West Ave Ste 110
Sioux Falls,SD57104
46-0306352 501c3 17,025       Sponsorship
(47) LifeLight Communications Inc
2601 S Western Ave
Sioux Falls,SD57105
46-0460742 501c3 10,000       Sponsorship
(48) Make-A-Wish Foundation of SD
1400 W 17th St
Sioux Falls,SD57104
46-0375953 501c3 10,000       Sponsorship
(49) Marshall Fire Department Relief Assn
201 E Saratoga St
Marshall,MN56258
41-0978542 501c4 7,500       Sponsorship
(50) McCrossan Boys Ranch
47135 260th St
Sioux Falls,SD57107
46-0311913 501c3 11,000       Sponsorship
(51) Mitchell Aquatic Club
PO Box 1371
Mitchell,SD57301
46-0461058 501c3 25,000       Sponsorship
(52) Mitchell Technical Institute Foundation
1800 E Spruce St
Mitchell,SD57301
46-0452950 501c3 80,250       Sponsorship
(53) Mitchell United Way
417 N Main St Suite 103
Mitchell,SD57301
46-1250302 501c3 6,000       Sponsorship
(54) Mount Marty College
1105 W 8th St
Yankton,SD57078
46-0283336 501c3 258,081       Sponsorship
(55) NAMI South Dakota
PO Box 88808
Sioux Falls,SD57109
36-3593027 501c3 27,500       Sponsorship
(56) National Field Archery Association Foundation
800 Archery Ln
Yankton,SD57078
33-0430066 501c3 25,000       Sponsorship
(57) National Kidney Foundation
30 East 33rd St 3rd fl
New York,NY10016
13-1673104 501c3 15,500       Sponsorship
(58) The National MS Society Upper Midwest Chapter
200 12th Ave S
Minneapolis,MN55415
41-0790658 501c3 16,000       Sponsorship
(59) NSU Foundation
620 15th Ave SE
Aberdeen,SD57401
23-7002314 501c3 150,000       Sponsorship
(60) OLLI at University Center
4801 N Career Ave
Sioux Falls,SD57107
46-6000364 State of SD 7,500       Sponsorship
(61) Philanthropy Promotions Inc
2601 W 60th St N
Sioux Falls,SD57107
87-0695596 501c3 20,000       Sponsorship
(62) Pierre Area Chamber of Commerce
800 W Dakota Ave
Pierre,SD57501
46-0177425 501c6 6,700       Sponsorship
(63) Pierre School District
211 S Poplar St
Pierre,SD57501
46-6001892 City of Pierre 10,000       Sponsorship
(64) Post 8 Baseball
PO Box 431
Pierre,SD57501
46-6008690 501c3 10,000       Sponsorship
(65) Prairie Family Business Association
4801 N Career Ave Ste 140
Sioux Falls,SD57107
46-6000364 State of SD 5,500       Sponsorship
(66) Presentation College
1500 N Main St
Aberdeen,SD57401
46-0280847 501c3 250,600       Sponsorship
(67) Presentation Sisters of the Blessed Virgin Mary
1500 N 2nd St
Aberdeen,SD57401
46-0253283 501c3 22,500       Sponsorship
(68) Pride in the Tiger Foundation
400 Tiger Dr
Marshall,MN56258
41-1948007 501c3 10,000       Sponsorship
(69) Ronald McDonald House Charities of SD
825 S Lake Ave
Sioux Falls,SD57104
46-0371152 501c3 20,000       Sponsorship
(70) Safe Harbor
PO Box 41
Aberdeen,SD57402
46-0344310 501c3 11,000       Sponsorship
(71) SculptureWalk Inc
300 S Phillips Ave Ste L104
Sioux Falls,SD57104
20-8535871 501c3 19,500       Sponsorship
(72) SD Youth Foundation Inc
1310 Main Ave S Ste 109
Brookings,SD57006
47-4832848 501c3 10,000       Sponsorship
(73) South Dakot Agriculatural & Rural Leadership Inc
1905 N Plaza Blvd
Rapid City,SD57702
36-4293293 501c3 10,000       Sponsorship
(74) South Dakota State University
Box 2201
Brookings,SD57007
46-6000364 501c3 8,010       Sponsorship
(75) SDSU Foundation
815 Medary Ave
Brookings,SD57006
46-0273801 501c3 165,000       Scholarship
(76) Sioux Empire Baseball Association
1601 W 44th Pl Ste 3
Sioux Falls,SD57105
41-1903475 501c3 16,000       Sponsorship
(77) Sioux Empire United Way
1000 N West Ave Ste 120
Sioux Falls,SD57104
46-0233701 501c3 84,240       Sponsorship
(78) Sioux Falls Catholic Schools
3100 W 41st St
Sioux Falls,SD57105
46-0413591 501c3 1,000,000       Sponsorship
(79) Sioux Falls Jazz & Blues Society
PO Box 1285
Sioux Falls,SD57101
46-0418356 501c3 20,000       Sponsorship
(80) Sioux Falls Youth Hockey Association
4235 W Mesa Pass
Sioux Falls,SD57106
46-0427805 501c3 17,500       Sponsorship
(81) South Dakota Chamber of Commerce and Industry
PO Box 190
Pierre,SD57501
46-0141180 501c6 7,500       Sponsorship
(82) South Dakota Hall of Fame
1480 S Main
Chamberlain,SD57325
46-0324210 501c3 25,000       Sponsorship
(83) South Dakota Community Foundation
1714 North Lincoln Ave
Pierre,SD57501
46-0398115 501c3 50,000       Sponsorship
(84) South Dakota Symphony Orchestra
301 S Main Ave
Sioux Falls,SD57104
46-6017026 501c3 57,250       Sponsorship
(85) Southeast Technical Institute Foundation
2320 N Career Ave
Sioux Falls,SD57107
36-4112897 501c3 20,000       Scholarship
(86) Special Olympics South Dakota
800 East I-90 Lane
Sioux Falls,SD57104
46-0359776 501c3 17,500       Sponsorship
(87) Stockyards Plaza Inc
PO Box 2042
Sioux Falls,SD57101
46-5391991 501c3 50,000       Sponsorship
(88) Teach for America-South Dakota
25 Broadway 12th fl
New York,NY10004
13-3541913 501c3 12,500       Sponsorship
(89) Tempo Soccer Club
PO Box 776
Tea,SD57064
47-5029561 501c3 7,000       Sponsorship
(90) United Way of Northeastern SD Inc
PO Box 1065
Aberdeen,SD57401
23-7086355 501c3 10,000       Sponsorship
(91) United Way of Yankton
610 W 23rd St Ste 11
Yankton,SD57078
46-0252854 501c3 12,500       Sponsorship
(92) University of Sioux Falls
1101 W 22nd St
Sioux Falls,SD57105
46-0224600 501c3 400,000       Sponsorship
(93) USD Foundation
PO Box 5555
Vermillion,SD57069
46-6018891 501c3 75,000       Scholarship
(94) USD Sanford School of Medicine
414 E Clark St
Vermillion,SD57069
46-6000364 State of SD 25,250       Sponsorship
(95) Vision Brookings Foundation
2301 Research Park Way Ste 113
Brookings,SD57006
46-0440746 501c3 20,000       Sponsorship
(96) Volunteers of America Dakotas
PO Box 89306
Sioux Falls,SD57109
23-7353508 501c3 15,000       Sponsorship
(97) Yankton Area Progressive Growth
803 E 4th St
Yankton,SD57078
46-0348636 501c6 60,000       Sponsorship
(98) Yankton School District 63-3
2410 W City Limits Rd
Yankton,SD57078
46-6003280 City of Yankton 15,000       Sponsorship
(99) Bishop Dudley Hospitality House
101 N Indiana Ave
Sioux Falls,SD57103
91-1836528 501c3 10,000       Sponsorship
(100) Avera McKennan Hospital
1325 S Cliff Ave
Sioux Falls,SD57105
46-0224743 501c3 4,180,006       Sponsorship
(101) Avera St Mary's
801 E Sioux Avenue
Pierre,SD57501
46-0230199 501c3 129,164       Sponsorship
(102) Avera Gettysburg
606 East Garfield
Gettysburg,SD57442
46-0234354 501c3 23,000       Sponsorship
(103) Avera Holy Family
826 North 8th Street
Estherville,IA51334
42-0680370 501c3 238,253       Sponsorship
(104) St Benedict Health Center
401 West Glynn Drive
Parkston,SD57366
46-0226738 501c3 11,458       Sponsorship
(105) Avera Queen of Peace Hospital
525 North Foster
Mitchell,SD57301
46-0224604 501c3 528,928       Sponsorship
(106) Sacred Heart Health Services
501 Summit Street
Yankton,SD57078
46-0225483 501c3 42,131       Sponsorship
(107) Avera at Home
5116 S Solberg Avenue
Sioux Falls,SD57108
46-0399291 501c3 166,525       Sponsorship
(108) Avera St Luke's
305 South State Street
Aberdeen,SD57401
46-0224598 501c3 51,449       Sponsorship
(109) Avera Marshall
300 South Bruce Street
Marshall,MN56258
41-0919153 501c3 80,720       Sponsorship
(110) Avera Tyler
240 Willow Street
Tyler,MN56178
41-0853163 501c3 9,981       Sponsorship
(111) American Red Cross
431 18th Street NW
Washington,DC20006
53-0196605 501c3 28,088       Sponsorship
(112) Weskota Foundation
604 1st Street NE
Wessington Springs,SD57382
46-0415751 501c3 7,569       Sponsorship
(113) Catholic Charities USA
2050 Ballenger Avenue
Alexandria,VA22314
53-0196620 501c3 35,588       Sponsorship
(114) Children's Museum of South Dakota
521 4th Street
Brookings,SD57006
26-3493723 501c3 38,657       Sponsorship
(115) Eureka Community Health Services
PO Box 517
Eureka,SD57437
46-0246437 501c3 833,813       Sponsorship
(116) Floyd Valley Healthcare
714 Lincoln Street NE
Lemars,IA51031
42-0928451 501c3 255,289       Sponsorship
(117) Friends for Health in Haiti
PO Box 122
Pewaukee,WI53072
20-4832316 501c3 9,450       Sponsorship
(118) Hegg Memorial Health Center
1202 21st Avenue
Rock Valley,IA51247
42-0932564 501c3 34,620       Sponsorship
(119) King of Glory Church
1001 East 17th Street
Sioux Falls,SD57104
45-2247326 501c3 7,500       Sponsorship
(120) Lakes Regional Healthcare
2301 Hwy 71
Spirit Lake,IA51360
42-6037582 501c3 24,782       Sponsorship
(121) Landmann-Jungman Memorial Hospital
600 Billars Street
Scotland,SD57059
46-6015787 501c3 78,964       Sponsorship
(122) Marshall County Healthcare Center
413 9th Street
Britton,SD57430
46-0380552 501c3 33,495       Sponsorship
(123) Pipestone County Medical Center
916 4th Avenue SW
Pipestone,MN56164
41-1392082 501c3 14,625       Sponsorship
(124) Platte Health Center
601 East 7th Street
Platte,SD57369
46-0239781 501c3 39,865       Sponsorship
(125) Weskota Manor Inc
609 1st Street NE
Wessington Springs,SD57382
46-0273307 501c3 68,787       Sponsorship
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
116
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2017
Page 2

Schedule I (Form 990) 2017
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) Haiti scholarships 27 34,597      
(2) Medical assistance to employees 67 125,278      
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
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, 2018, the Organization made contributions to other non-public charities 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) 2017



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