﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-08-14T12:32:20-04:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>460434947</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>ELO PROF LLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>PO BOX 249</AddressLine1Txt>
        <CityNm>MITCHELL</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57301</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>460213945</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SOUTH DAKOTA STATE MEDICAL</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>ASSOCIATION</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>SOUT</BusinessNameControlTxt>
      <PhoneNum>6053361965</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2600 WEST 49TH STREET STE 100</AddressLine1Txt>
        <CityNm>SIOUX FALLS</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57105</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>BARB SMITH</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>6053361965</PhoneNum>
      <SignatureDt>2024-08-01</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>JAMIE A ELDEEN CPA</PreparerPersonNm>
      <PTIN>P00736101</PTIN>
      <PhoneNum>6059967717</PhoneNum>
      <PreparationDt>2024-08-06</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-08-08 14:25:15Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc3" referenceDocumentId="RetDoc8">
      <PrincipalOfficerNm>BARB SMITH</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2600 W 49TH ST STE 200</AddressLine1Txt>
        <CityNm>SIOUX FALLS</CityNm>
        <StateAbbreviationCd>SD</StateAbbreviationCd>
        <ZIPCd>57105</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>2881354</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.SDSMA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1881</FormationYr>
      <LegalDomicileStateCd>SD</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO IMPROVE MEDICAL PRACTICE THROUGH ORGANIZATION OF THE MEDICAL DOCTORS OF THE STATE OF SOUTH DAKOTA.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>5</TotalEmployeeCnt>
      <TotalGrossUBIAmt>102949</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>39606</NetUnrelatedBusTxblIncmAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>839042</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>981271</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>315187</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>290155</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>475742</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>393850</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>1629971</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>1665276</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>201750</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>642182</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>698538</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>491332</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>486213</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>1133514</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>1386501</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>496457</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>278775</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>10219457</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>10777740</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>1155638</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>899857</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>9063819</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>9877883</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>THE SOUTH DAKOTA STATE MEDICAL ASSOCIATION IS DEVOTED TO PROMOTING THE ART AND SCIENCE OF MEDICINE; PROTECTING AND IMPROVING THE HEALTH OF THE PUBLIC; AND PROVIDING LEADERSHIP AND ADVOCACY IN THE FILED OF QUALITY HEALTHCARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <Desc>TO IMPROVE MEDICAL PRACTICE THROUGH ORGANIZATION OF THE MEDICAL DOCTORS IN THE STATE OF SOUTH DAKOTA.</Desc>
      <DescribedInSection501c3Ind>false</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>false</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc4">false</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc4">true</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc5">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc5">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc5">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc5">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc5">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc5">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc5">true</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc5">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc5">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc5">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc5">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc5">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc5">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc6">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc6">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc7">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>12</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>5</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>true</LocalChaptersInd>
      <PoliciesReferenceChaptersInd>true</PoliciesReferenceChaptersInd>
      <Form990ProvidedToGvrnBodyInd>false</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>BARB SMITH</PersonNm>
        <PhoneNum>6053361965</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2600 W 49TH ST STE 200</AddressLine1Txt>
          <CityNm>SIOUX FALLS</CityNm>
          <StateAbbreviationCd>SD</StateAbbreviationCd>
          <ZIPCd>57105</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARB SMITH</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>209889</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>16673</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENISE S HANISCH MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>5000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENNIFER J TINGUELY</PersonNm>
        <TitleTxt>PRESIDENT-EL</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN M ANDERSON MD</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH A HANSEN MD</PersonNm>
        <TitleTxt>SECRETARY/TR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LUCIO N MARGALLO II MD</PersonNm>
        <TitleTxt>PAST PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>5000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA B BROWN MD</PersonNm>
        <TitleTxt>POLICY COUNC</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEEPAK M GOYAL MD</PersonNm>
        <TitleTxt>AT-LARGE DIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MANDI GREENWAY BIETZ MD</PersonNm>
        <TitleTxt>AT-LARGE DIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BENJAMIN D MEYERINK MD</PersonNm>
        <TitleTxt>AT-LARGE DIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>219889</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>16673</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>479832</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>479832</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>JOURNAL OF MEDICINE</Desc>
        <BusinessCd>541800</BusinessCd>
        <TotalRevenueColumnAmt>156264</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>53315</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>102949</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER GRANTS</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>151050</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>151050</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MMIC CONTRACT</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>125622</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>125622</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ANNUAL MEETING</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>38797</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>38797</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>29706</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29706</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>981271</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>188820</TotalRevenueColumnAmt>
        <ExclusionAmt>188820</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>705233</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>400753</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>304480</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>304480</TotalRevenueColumnAmt>
        <ExclusionAmt>304480</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>811539</SecuritiesAmt>
        <OtherAmt>105121</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>810075</SecuritiesAmt>
        <OtherAmt>5250</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1464</SecuritiesAmt>
        <OtherAmt>99871</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>101335</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24214</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>77121</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>REIMBURSEMENTS</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>89370</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>89370</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>89370</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>1665276</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>991906</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>102949</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>570421</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>201750</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>226562</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>296521</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>64053</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>73918</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>37484</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>12978</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>14446</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>128597</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>27586</TotalAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>86560</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>26343</TotalAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>48624</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>44541</TotalAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>33725</TotalAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>8290</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>6421</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>READERSHIP COSTS - ALLOC</Desc>
        <TotalAmt>18908</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BANK CHARGES &amp; CC FEES</Desc>
        <TotalAmt>11033</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PRESIDENT STIPEND</Desc>
        <TotalAmt>10000</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>STORAGE</Desc>
        <TotalAmt>3186</TotalAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>4975</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>1386501</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1009555</BOYAmt>
        <EOYAmt>299299</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1232070</BOYAmt>
        <EOYAmt>1016212</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>15643</BOYAmt>
        <EOYAmt>29825</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>5787</BOYAmt>
        <EOYAmt>28431</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>4648560</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1752740</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>2916019</BOYAmt>
        <EOYAmt>2895820</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>5035469</BOYAmt>
        <EOYAmt>5790752</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <EOYAmt>716298</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>4914</BOYAmt>
        <EOYAmt>1103</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>10219457</BOYAmt>
        <EOYAmt>10777740</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>530734</BOYAmt>
        <EOYAmt>228573</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>601584</BOYAmt>
        <EOYAmt>642041</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>23320</BOYAmt>
        <EOYAmt>29243</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1155638</BOYAmt>
        <EOYAmt>899857</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <CapStkTrPrinCurrentFundsGrp>
        <BOYAmt>5508161</BOYAmt>
        <EOYAmt>6427835</EOYAmt>
      </CapStkTrPrinCurrentFundsGrp>
      <PdInCapSrplsLandBldgEqpFundGrp>
        <BOYAmt>3240314</BOYAmt>
        <EOYAmt>3532083</EOYAmt>
      </PdInCapSrplsLandBldgEqpFundGrp>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>315344</BOYAmt>
        <EOYAmt>-82035</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>9063819</BOYAmt>
        <EOYAmt>9877883</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>10219457</BOYAmt>
        <EOYAmt>10777740</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>278775</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>559104</NetUnrlzdGainsLossesInvstAmt>
      <InvestmentExpenseAmt>-21031</InvestmentExpenseAmt>
      <OtherChangesInNetAssetsAmt>-2784</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
    </IRS990>
    <IRS990ScheduleC documentId="RetDoc4">
      <SubstantiallyAllDuesNondedInd>false</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>false</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>false</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>533147</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>73121</NonDeductibleLbbyngPltclCYAmt>
      <NonDedLbbyngPltclCyovAmt>-81123</NonDedLbbyngPltclCyovAmt>
      <NonDeductibleLbbyngPltclTotAmt>-8002</NonDeductibleLbbyngPltclTotAmt>
      <AggregateReportedDuesNtcAmt>53315</AggregateReportedDuesNtcAmt>
      <TaxableAmt>-61317</TaxableAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc5">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>328650</OtherCostOrOtherBasisAmt>
        <BookValueAmt>328650</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4070038</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1558680</DepreciationAmt>
        <BookValueAmt>2511358</BookValueAmt>
      </BuildingsGrp>
      <TotalBookValueLandBuildingsAmt>2840008</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>CERTIFICATES OF DEPOSIT</Desc>
        <BookValueAmt>716298</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>716298</TotalBookValueSecuritiesAmt>
      <FederalIncomeTaxLiabilityAmt>5923</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>TENANT SECURITY DEPOSITS</Desc>
        <Amt>23320</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>29243</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc6">
      <GrantRecordsMaintainedInd>false</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SOUTH DAKOTA STATE MEDICAL FOUNDATI</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2600 W 49TH ST STE 200</AddressLine1Txt>
          <CityNm>SIOUX FALLS</CityNm>
          <StateAbbreviationCd>SD</StateAbbreviationCd>
          <ZIPCd>57105</ZIPCd>
        </USAddress>
        <RecipientEIN>466012680</RecipientEIN>
        <CashGrantAmt>200000</CashGrantAmt>
        <PurposeOfGrantTxt>SCHOLARSHIP</PurposeOfGrantTxt>
      </RecipientTable>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc7">
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BARB SMITH</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>209889</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>16673</DeferredCompensationFlngOrgAmt>
        <TotalCompensationFilingOrgAmt>226562</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS 1,718 ACTIVE, HONORARY, STUDENT AND RESIDENT MEMBERS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS 1,277 VOTING MEMBERS, CONSISTING OF ACTIVE AND HONORARY MEMBERS. 8 OF THE BOARD MEMBERS ARE ELECTED BY THE MEMBERSHIP AND 3 ARE APPOINTED BY THE POLICY COUNCIL. THE BOARD MEMBERS HAVE ONE-YEAR TEMRS. THE POLICY COUNCIL IS COMPOSED OF 42 COUNCILORS (WHICH INCLUDES THE 11 BOARD MEMBERS). EACH OF THE 42 COUNCILORS HAS AN ALTERNATE COUNCILOR TO FILL THE SEAT IF UNABLE TO ATTEND A MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR, BARB SMITH, REVIEWS AND APPROVES FORM 990 BEFORE IT IS FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL OFFICERS AND DIRECTORS ARE REQUIRED ANNUALLY TO SIGN A CONFLICT OF INTEREST POLICY. COUNCIL MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM ANY DELIBERATIONS AND DECISIONS IN WHICH THEY HAVE A CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THE EXECUTIVE DIRECTOR USING COMPARABILITY DATA (AS AVAILABLE) AND DOCUMENTS THE PROCEEDINGS IN THE COMMITTEE'S MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>SAME AS PROCESS FOR TOP OFFICIAL</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>BOOK / TAX DEPRECIATION DIFFERENCE 673 BOOK / TAX GAIN ON DISPOSAL DIFFERENCE 5,250 INCOME TAX EXPENSE -8,707 TOTAL -2,784</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>