FURP.ORG / PUBLIC DATA EXPLORER

AVERA MARSHALL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
AVERA MARSHALL (EIN 41-0919153)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-14
IRS object ID
202431359349309793
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-14T15:17:10-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410919153EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera MarshallBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone5075329661PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP562581934ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJulie LauttPersonNm
Person TitleCFO Avera HealthPersonTitleTxt
Phone5075329661PhoneNum
Signature2024-05-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJuliePersonFirstNm
Person LastLauttPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2024-04-30PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Avera Marshall Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDebbie StreierPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP562581934ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$138,589,388GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.avera.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1944FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPromotion of healthActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee831TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$15,836TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$8,617NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,472,684PYContributionsGrantsAmt
CY Contributions Grants$766,756CYContributionsGrantsAmt
PY Program Service Revenue$138,944,450PYProgramServiceRevenueAmt
CY Program Service Revenue$137,508,574CYProgramServiceRevenueAmt
PY Investment Income$213,148PYInvestmentIncomeAmt
CY Investment Income$166,465CYInvestmentIncomeAmt
PY Other Revenue$277,385PYOtherRevenueAmt
CY Other Revenue$114,305CYOtherRevenueAmt
PY Total Revenue$143,907,667PYTotalRevenueAmt
CY Total Revenue$138,556,100CYTotalRevenueAmt
PY Grants And Similar Paid$3,146PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,371CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$64,429,869PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$64,889,641CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,074CYTotalFundraisingExpenseAmt
PY Other Expenses$71,859,223PYOtherExpensesAmt
CY Other Expenses$69,954,268CYOtherExpensesAmt
PY Total Expenses$136,292,238PYTotalExpensesAmt
CY Total Expenses$134,851,280CYTotalExpensesAmt
PY Revenues Less Expenses$7,615,429PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,704,820CYRevenuesLessExpensesAmt
Total Assets BOY$101,604,276TotalAssetsBOYAmt
Total Assets EOY$91,701,135TotalAssetsEOYAmt
Total Liabilities BOY$39,410,747TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,375,960TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$62,193,529NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$67,325,175NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$123,868,488ExpenseAmt
Grant$7,371GrantAmt
Revenue$137,536,519RevenueAmt
DescAvera Marshall's mission is to provide healthcare services to Marshall, Minnesota residents and residents of the surrounding area. Avera Marshall is a 501(c)(3) organization affiliated with Avera Health. Avera Marshall consists of a 25-bed critical access hospital plus 10 behavioral health beds and a 76-bed nursing home in Marshall, Minnesota, six physician clinics and four optometry clinics. The program services offered include primary care, general surgery, neurology (via telemed), dermatology, pediatrics, orthopedics, OB/GYN, urology, oncology, podiatry, psychiatry, nephrology, radiology, optometry, ophthalmology, level III trauma center, ICU, speech therapy, physical therapy, and occupational therapy. Avera Marshall provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera Marshall Hospital 1,350 Acute patient discharges 402 Newborn patient discharges 15 Swing bed patient discharges 76,859 Outpatient visits 78 Swing-bed patient days 595 Newborn patient days 47,751 Clinic visitsAvera Morningside Heights Care Center 26,232 Long-term resident days 116 Long Term Care patient dischargesAvera Marshall maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $899,770.Avera Marshall also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera Marshall upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera Marshall engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed.Desc
Total Program Service Expenses$123,868,488TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document97IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee831EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jamie SchaeferBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6053223992PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13900 W Avera Dr Ste 300AddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57108ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Debbie Streier
Regional President & CEO41.504.50Yes (X)Yes (X)$0$470,488$38,557
George Jorgensen
Chair1.501.50Yes (X)Yes (X)$0$0$0
Amanda Sieling
Vice Chair1.501.50Yes (X)Yes (X)$0$0$0
Todd Bock
Board Member1.501.50Yes (X)$0$0$0
Stephen Crim
Board Member1.5013.50Yes (X)$0$48,817$0
Quentin Fixen
Board Member1.501.50Yes (X)$0$0$0
Greg Goepferich
Board Member1.501.50Yes (X)$0$0$0
Sr Mary Jaeger
Board Member1.506.50Yes (X)$0$0$0
Laurie Johansen
Board Member1.501.50Yes (X)$0$0$0
LaVonne Koenen
Board Member1.503.50Yes (X)$0$0$0
Curtis Louwagie MD
Board Member/Opthalmology41.501.50Yes (X)$695,557$0$53,216
Joyce Strootman
Board Member1.501.50Yes (X)$0$0$0
Sr Jodie Zimmerman
Board Member1.501.50Yes (X)$0$0$0
Julie Lautt
CFO Avera Health;Secretary/Treasurer0.1046.30Yes (X)$0$1,086,452$17,088
Emmy Ho MD
Orthopedics & Surgery40.000.00$905,882$0$46,524Yes (X)
Daniel Lister MD
Orthopedics & Surgery40.000.00$875,715$0$41,586Yes (X)
Jonna Maas MD
Internal Medicine & Hospitalist40.000.00$684,019$0$45,397Yes (X)
Timothy Michals MD
Pediatrics & Internal Medicine40.000.00$732,230$0$15,250Yes (X)
Arthur Rillo MD
Family Medicine/OB40.000.00$735,911$0$46,560Yes (X)
Sharon Williams
Former Sec/Treas & VP Finance0.0040.00$0$196,827$36,819Yes (X)
Doris Derynck
Former VP Clinical Operations/CNO0.000.00$271,044$0$20,032Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,900,358TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,802,584TotReportableCompRltdOrgAmt
Total Other Compensation$361,029TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K134IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Health
3900 W Avera Dr Ste 301Sioux FallsSD57108Shared Services$7,450,164
Big Stone Therapies Inc
500 Cross StBig Stone CitySD571175045Therapy Services$5,705,138
Journey Group Companies
PO Box 2728Sioux FallsSD571012728Construction Services$4,249,055
AMN Healthcare Inc
AMN Chicago Lockbox 2735 CollectionChicagoIL606932735Labor Services$1,751,514
Unitimed Recruiting Resources LLC
PO Box 8265Rapid CitySD57709Locum Services$949,502
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Related Organizations$160,911RelatedOrganizationsAmt
Government Grants$361,901GovernmentGrantsAmt
All Other Contributions$243,944AllOtherContributionsAmt
Total Contributions$766,756TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Service Revenue621110$115,267,123$115,251,287$15,836
Federally Qualified Health Center621990$15,882,617$15,882,617
Pharmacy Revenue456110$2,251,832$2,251,832
Patient and Clinic Revenue621110$30,519$30,519

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,076,483TotalRevenueColumnAmt
Related Or Exempt Func Income$4,076,483RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$137,508,574TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$159,600TotalRevenueColumnAmt
Exclusion$159,600ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$103,812RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$33,288RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$70,524RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,524TotalRevenueColumnAmt
Exclusion$70,524ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,365SecuritiesAmt
Other$4,500OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,365SecuritiesAmt
Other$4,500OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,865TotalRevenueColumnAmt
Exclusion$6,865ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
A/R Interest900099$33,181$33,181
Sports Programs900099$10,600$10,600
FieldValueIRS element (for citing)
Other Revenue Total$43,781OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$138,556,100TotalRevenueColumnAmt
Related Or Exempt Func Income$137,536,519RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$15,836UnrelatedBusinessRevenueAmt
Exclusion$236,989ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,371TotalAmt
Program Services$7,371ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$777,588TotalAmt
Program Services$777,588ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$51,968,769TotalAmt
Program Services$50,989,306ProgramServicesAmt
Management And General$979,463ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,869,063TotalAmt
Program Services$1,832,930ProgramServicesAmt
Management And General$36,133ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,052,943TotalAmt
Program Services$6,875,172ProgramServicesAmt
Management And General$177,771ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,221,278TotalAmt
Program Services$3,154,315ProgramServicesAmt
Management And General$66,963ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$40,627TotalAmt
Management And General$40,627ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,003TotalAmt
Management And General$1,003ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$32,134,578TotalAmt
Program Services$25,423,313ProgramServicesAmt
Management And General$6,711,265ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,343TotalAmt
Program Services$1,326ProgramServicesAmt
Management And General$17ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$696,196TotalAmt
Program Services$501,430ProgramServicesAmt
Management And General$194,154ManagementAndGeneralAmt
Fundraising$612FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$378,758TotalAmt
Program Services$366,065ProgramServicesAmt
Management And General$12,693ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,097,225TotalAmt
Program Services$1,769,813ProgramServicesAmt
Management And General$327,412ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$752,656TotalAmt
Program Services$749,110ProgramServicesAmt
Management And General$3,546ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$196,593TotalAmt
Program Services$194,234ProgramServicesAmt
Management And General$2,359ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$764,581TotalAmt
Program Services$673,831ProgramServicesAmt
Management And General$90,750ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,333,018TotalAmt
Program Services$4,825,983ProgramServicesAmt
Management And General$506,626ManagementAndGeneralAmt
Fundraising$409FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$496,908TotalAmt
Program Services$322,579ProgramServicesAmt
Management And General$174,329ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies$23,581,695$23,574,159$7,495$41
Equipment Lease/Rental$131,175$129,917$1,258
Bad Debt$45,000$45,000
Provision for Income Ta$7,400$7,400

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,295,512TotalAmt
Program Services$1,647,646ProgramServicesAmt
Management And General$1,647,854ManagementAndGeneralAmt
Fundraising$12FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$134,851,280TotalAmt
Program Services$123,868,488ProgramServicesAmt
Management And General$10,981,718ManagementAndGeneralAmt
Fundraising$1,074FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,494,914BOYAmt
EOY$1,177,591EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,637,090BOYAmt
EOY$14,199,316EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,865,240BOYAmt
EOY$3,132,295EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$834,577BOYAmt
EOY$1,402,764EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$111,299,404LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$62,180,613LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$48,547,425BOYAmt
EOY$49,118,791EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$32,741,259BOYAmt
EOY$17,239,490EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,004,785BOYAmt
EOY$1,416,664EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$478,986BOYAmt
EOY$4,014,224EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$101,604,276BOYAmt
EOY$91,701,135EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,539,591BOYAmt
EOY$8,567,236EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$149,663BOYAmt
EOY$62,024EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,313,469BOYAmt
EOY$12,805,303EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$16,475BOYAmt
EOY$23,070EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$14,053,063BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,338,486BOYAmt
EOY$2,918,327EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,410,747BOYAmt
EOY$24,375,960EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,436,672BOYAmt
EOY$63,455,740EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,756,857BOYAmt
EOY$3,869,435EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$62,193,529BOYAmt
EOY$67,325,175EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$101,604,276BOYAmt
EOY$91,701,135EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,704,820ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,266,033NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$160,793OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$1,003OtherActivitiesAmt
Total Lobbying Expenditures$1,003TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAvera Marshall paid dues to organizations which have a portion of the dues attributed to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$711,109BeginningYearBalanceAmt
Contributions$1,106ContributionsAmt
Investment Earnings Or Losses$49,515InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$4,462OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$757,268EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$794,733BeginningYearBalanceAmt
Contributions$7,201ContributionsAmt
Investment Earnings Or Losses-$82,336InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$8,489OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$711,109EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$685,848BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$119,848InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$10,963OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$794,733EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$694,135BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses-$2,726InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$5,561OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$685,848EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$676,934BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$22,615InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$5,414OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$694,135EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.59518PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.40482TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,004,636OtherCostOrOtherBasisAmt
Book Value$1,004,636BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$75,367,455OtherCostOrOtherBasisAmt
Depreciation$38,279,313DepreciationAmt
Book Value$37,088,142BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,632OtherCostOrOtherBasisAmt
Depreciation$12,242DepreciationAmt
Book Value$5,390BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,750,228OtherCostOrOtherBasisAmt
Depreciation$23,093,587DepreciationAmt
Book Value$9,656,641BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,159,453OtherCostOrOtherBasisAmt
Depreciation$795,471DepreciationAmt
Book Value$1,363,982BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$49,118,791TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Interest in Avera Health Foundation$4,160,313F
Avera Pooled Investments$13,079,177F
FieldValueIRS element (for citing)
Total Book Value Securities$17,239,490TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Estimated Third-Party Payor Settlements$761,520
Right of Use Operating Lease Obligations$2,156,807
FieldValueIRS element (for citing)
Total Liability$2,918,327TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:The Organization holds funds on behalf of its residents.
Part V, Line 4:The Organization's endowments consist of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any,) are classified and reported based on the existence or absence of donor-imposed restrictions. The endowment fund calculation was changed in current year and all amounts for prior years have been updated to properly reflect the new calculation.
Part X, Line 2:Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$415,861TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$415,861NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,633,252TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,271,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,362,238NetCommunityBenefitExpnsAmt
Total Expense0.01010TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,049,113TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,271,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,778,099NetCommunityBenefitExpnsAmt
Total Expense0.01320TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,206,364TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,259,008DirectOffsettingRevenueAmt
Net Community Benefit Expns$947,356NetCommunityBenefitExpnsAmt
Total Expense0.00700TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$160,214TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$160,214NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,070,823TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,798,806DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,272,017NetCommunityBenefitExpnsAmt
Total Expense0.06130TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,437,401TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,057,814DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,379,587NetCommunityBenefitExpnsAmt
Total Expense0.06950TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,486,514TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,328,828DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,157,686NetCommunityBenefitExpnsAmt
Total Expense0.08270TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$231,438TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$231,438NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,213TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$42,213NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$273,651TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$273,651NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,812,960BadDebtExpenseAmt
Reimbursed By Medicare$23,877,143ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,115,451CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$761,692MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera Marshall Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56258ZIPCd
FieldValueIRS element (for citing)
Website AddressSee Part V Section CWebsiteAddressTxt
State License00343StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other6 Provider Based ClinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Avera MarshallBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V Section COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part V Section COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Avera MarshallPart V, Section B, Line 5: The Avera Marshall Regional Medical Center Community Health Needs Assessment (CHNA) was conducted in collaboration and partnership with community members, community organizations, stakeholders from local public health and internal stakeholders. These partners assisted in the development and analysis of assessment information through a series of data collection processes. In addition, Avera Marshall partnered with Southwest Health and Human Services (SWHHS) to provide a more comprehensive look into the social determinants of health and wellness in the communities we serve. SWHHS shared their draft of their 2019 Quality of Life Survey with us, which allowed us to incorporate the perspectives of 488 individuals on what defines a healthy community. In addition, we talked to 82 community members of diverse backgrounds and used a five member CHNA advisory committee that represented various aspects of our service area: academic, governmental, non-profit, industry, and vulnerable populations. Care was taken to consider the perspectives of the underserved populations - Karen, Hispanic/Latino, African American, and Somali. We also consulted with Vondie Woodbury of The Woodbury Group.
Avera MarshallPart V, Section B, Line 6a: The Avera Marshall region has three hospitals: Avera Marshall, Avera Tyler, and Avera Granite Falls. As it is that all three hospitals are in the Avera Health system, share equally the same demographic and geographic area, and have shared senior leadership, the conducted CHNA was a regional CHNA that was inclusive of all three hospitals. Additionally, the implementation plan established applies to all three facilities.
Avera MarshallPart V, Section B, Line 6b: Southwest Health and Human Services
Avera MarshallPart V, Section B, Line 11: A community health needs assessment was completed in FY2022. The following community health priority areas were identified: Cultural barriers that impact healthcare, including but not limited to interpretive services; Mental Health; and Transportation, as it relates to access for healthcare services. Avera Marshall developed an implementation plan for each of these three priorities. Mental Health:Avera Marshall's goal around mental health will be to lower depression rates and engage in issues around suicide prevention. Partners we are working with: Public Health, Clergy, Community Groups, Southwest Mental Health, AMG general practice providers, schools, and AMG Mental health providers. Steps we are taking: - OB patients are being screened for mental health needs and connected to our mental health services as needed. - Avera Medical Group (AMG) tracks depression amongst our inpatient and outpatient Medicaid populations. - AMG providers discuss depression with patients who show signs of depression and help connect them with our mental health services. - Working with Southwest Mental Health by informing mental health patients of the resources provided by the agency, especially their mobile mental health crisis team. - Utilizing Minnesota Department of Health (MDH) resources related to the 988 mental health hotline in our community education events. - Conducting a community wide suicide prevention campaign called, "Ask the Question" to provide community members information about how to talk to friends and family about suicide in order to reduce the risk of suicide. This program is engaging public health, providing education to church leaders, and delivering public service messages. - Our Karen community health worker is providing continuity of service for Karen patients referred to Southwest Mental Health. This continuity of service includes helping patients complete admitting paperwork and attending initial intake evaluation appointments.Cultural barriers that impact healthcare, including but not limited to interpretive services:Avera Marshall's goal around cultural barriers is to improve interpretive services, aid in navigating the healthcare system, and educate our traditionally underserved populations in matters related to disease prevention and vaccinations. Partners we are working with: Public Health, Non-Avera Medical Providers, Churches, Community Groups, Local Employers, Medical Providers, ARCH Language Network, and Avera Staff. Steps we are taking: - Hired a Spanish speaking provider who's able to provide both primary care and OB services in Spanish. - Avera Research conducted a focus group for the Karen community in Marshall to discuss cultural barriers to participating in clinical research trials. - Working with local employers of traditionally underserved populations to improve understanding of insurance programs, the need for preventative medicine, and vaccinations. - Signage was added to the chapel to reflect cardinal directions for those faiths that use directions for prayer. - Karen community health worker is working with Avera pediatric clinic in Sioux Falls to provide continuity of care for regional Karen patients. - Avera contracted with Language Line to have additional interpretation resources for those languages that are often difficult to find interpreters for such as: Karen, Somali, and ASL. - Karen community health worker began working with the ARCH language network to recruit Karen speakers into their medical interpretation program. - We applied for a grant with the State of Minnesota to hire two more community health workers. Though we did not receive this grant, we have applied for another grant with Blue Cross Blue Shield of Minnesota for the same purpose of hiring community health workers for our Hispanic and Somali populations. - Preliminary investigation into the possibility of completing Form N648 for those seeking citizenship in our region. This would alleviate the burden of traveling 170 miles to meet with a physician able to complete this form. - Provided health related education for the Karen community by presenting information about health-related topics prior to their Sunday worship services.Transportation, as it relates to access for healthcare services:Avera Marshall's goal is to improve transportation access for health care appointments for those who do not have transportation and develop stronger relationships with transportation services within our service area. Partners we are working with: Local and State Public Health, City of Marshall, United Community Action Partnership, Local Medical Transport Companies, and Avera Staff (CHW and Care Coordination). Steps we are taking: - Developed relationship with Southwest Minnesota Taxi to help with transportation needs that fall outside of other social services. - We worked with the city to add a public bus stop to our Federally Qualified Health Center (FQHC) location. - Karen community health worker provides transportation coordination for Karen community as needed. This allows care coordination to focus on more complex cases and will allow the community health worker to provide more targeted intervention on transportation for Karen community members. - Meeting with public health and local medical transportation companies (including volunteer programs) to engage in dialogue about how we can best work together to provide short and long-distance transportation for medical services throughout the region. - When emergency medical transportation is utilized, providing clear directions to family and friends of the patient to the destination facility. Additionally, when those family and friends do not have transportation have social work/care coordination find a local transport company to bring at least one family member to the destination facility.There are needs identified in the Community Health Needs Assessment which Avera Marshall has not included in its priority implementation plan. These needs were not included in the priority needs implementation plan in order to focus resources on the three most urgent health care needs. The needs not being directly addressed in the CHNA implementation plan include: - Alcohol and drug abuse, - Access to cancer center screening, and - Issues related to aging problems.Though not in the implementation plan, we continue to address these needs throughout the Avera Marshall Region using the appropriate standards of care.
Avera MarshallPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera MarshallPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency room, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera MarshallPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera MarshallPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Part V, Section B, Lines 7a, 7b and 10a:avera.org/about/community-health-needs-assessments/#marshall
Part V, section B, Line 16a-cThe FAP, FAP Application, and Plain Language Summary are available at:avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/
Part V, Section A website address:avera.org/locations/marshall/
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Avera Morningside Heights Care Center
300 S Bruce StreetMarshallMN56258Nursing home
2 - Avera Therapy Marshall
1521 Carlson StreetMarshallMN56258Physical, speech, and occupational therapy
3 - AMG Optometry Redwood Falls
500 E Bridge StreetRedwood FallsMN56283Optometry, ophthalmology, optical
4 - AMG Optometry Tracy
505 State StreetTracyMN56175Optometry, ophthalmology, optical
5 - AMG Optometry Springfield
602 N Jackson AveSpringfieldMN56087Optometry, ophthalmology, optical

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted.
Part I, Line 6a:The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/.
Part I, Line 7:Charity care was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost report. Subsidized health services were calculated based on a combination of the Medicare cost report and actual expenses recorded to the general ledger. Community health improvement services, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded to the general ledger.
Part I, Line 7g:Provider based clinic costs are included in subsidized health services. Revenues of $479,211 and costs of $644,407 were included for a net community benefit of $165,196.
Part II, Community Building Activities:The organization provides education to community groups, has staff that serve on various committees/boards, pays the salaries of two police officers, provides leadership development and training for community members, and donates to various community organizations.
Part III, Line 2:The amount on line 2 represents implicit price concessions and bad debts. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. Bad debt reflects amounts that will not be paid by patients based on an adverse change in the patient's ability to pay.
Part III, Line 4:The footnote to the Organization's financial statements that describes implicit price concessions and bad debt is located in the audited financial statement report on pages 19 and 20.
Part III, Line 8:Avera Marshall provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare programs are not completely covered, the Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.
Part III, Line 9b:If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven.
Part VI, Line 2:Avera Marshall uses many sources to assess the needs of the community, including their medical staff's daily interactions with their patients and the community. Additional sources include federal, state, and county statistical information, public health data, internal data, and input from community members, businesses, city, and other local agencies. To gain community member input the following processes are used: interviews, focus groups, neighborhood canvassing, and surveys. Other sources have included a CHNA advisory committee that included representatives from multiple service areas in the community, including academic, governmental, non-profit, industry, and vulnerable populations. Care is taken with all information sourcing to make sure we gain the perspective of the underserved populations: Karen, Hispanic/Latino, African American, and Somali. Avera Marshall also partners with many area organizations, including Southwest Health and Human Services (SWHHS,) where we share information, such as their Quality-of-Life survey.
Part VI, Line 3:Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs.
Part VI, Line 4:Avera Marshall is a 25-bed critical access hospital in Marshall, Minnesota, which includes an additional 10 behavioral health beds. The primary service area is defined as Lyon County, Minnesota, including the communities of Marshall, Minneota, Ghent, Taunton, Lynd, Russell, Cottonwood, Tracy, Balaton and Garvin. Marshall is the county seat. According to the U.S. Census Bureau Quick Facts 2021 data, the estimated population of Lyon County as of July 1, 2021 is 25,231 and is predominately white at 88.8%. It is estimated that 17.0% of the population is 65 years and over. The median household income is $57,274 with an 8.8% poverty rate. Uninsured individuals under age 65 is estimated at 7.8%.
Part VI, Line 5:Avera Marshall is one of the largest employers in the area and is committed to helping its community members get as much of their healthcare as close to home as possible. To this end, any surplus funds are reinvested in facilities to improve patient care, add/replace necessary equipment, and fund needed facility upgrades. To further ensure local care, medical staff privileges are extended to all qualified physicians in the community.In addition, Avera Marshall is the sole provider for hospital inpatient care, the only physician staffed 24/7 ER Level III Trauma offering coverage no matter the ability to pay, birthing center, and full-service surgery center. Avera Marshall provides numerous services which do not produce a profit. An example of this is psychiatric services provided by the facility. This is a subsidized health service. Some of the other services include dialysis, in-home palliative care, diabetic education, and eye injections at rural outreach facilities to decrease patient's travel time for patient's with limited vision. Avera Marshall is committed to taking care of all individuals, no matter their ability to pay. Charity care is always available for those with a diminished ability to pay. We staff patient advocates, who meet with patients with high deductible plans and high-cost medications to find drug programs to help cover a patient's out of pocket costs. We also work with patients to complete presumptive Medicaid, full Medicare applications, answer questions on the MNSure insurance programs, help patients coordinate their insurance benefits and complete charity care applications for Avera and Access Health services. In addition, on January 1, 2022, Avera Marshall partnered with Rural Health Care Inc. to open Access Health-Marshall. This clinic offers a full range of primary healthcare services. Avera Marshall offers a number of services that are free or low cost, including: classes such as childbirth and various other support groups, participates in the Mother's Milk program by purchasing donated breast milk and providing it to babies free of charge during their hospital stay, Planet Heart community screenings with reduced imaging fees in addition to free vein screenings, rape and sexual assault services not fully funded by the county, Hospice medical provider not billed to patients, sharps and unused medical disposal services, offer a recycle eye wear program, transportation vouchers for patients without any options, physicals for sports are given to students who have no means to pay but wish to participate in athletic school activities, impact testing is provided to local schools to help support concussion testing and ensure student athletes do not return before they are ready, basic supply items are donated to school nurse providers for triage care, and in partnership with Big Stone Therapies, Avera Marshall provides athletic trainers to many high schools throughout the Marshall region with reduced cost to the school district. Avera Marshall also supports the local college, Southwest Minnesota State University with their medical needs for both students and athletes. Community out-reach programs are done in partnership with local underserved communities and businesses. Avera also hired a community health worker to support the Karen community by helping to coordinate their health needs and provide in-person interpretation services. In addition, virtual and other in person interpretation services are offered in several different languages. Staff Care Coordinators are also employed to help high-need patients navigate their health care needs. Educational experiences for school-aged children, students needing work study experience, and med student internships are offered. On an annual basis Avera Marshall provides scholarships for medical students and high-school students. Avera Marshall also partners with the Transition-to-Work Program or Project SEARCH. This program allows local high-school students with significant intellectual disabilities to be employed in nontraditional, complex, and rewarding jobs, allowing them to gain real-life work experience in order to achieve competitive employment upon graduation. The organization's governing body is comprised of volunteer members who reside in the community. Avera Marshall's leadership team, physicians, and general staff are encouraged to participate in civic and community organizations. Avera Marshall also offers many opportunities for community members to volunteer within the hospital, long term care, home care, hospice, and thrift store settings. Finally, to further safety for the community residents and patients, Avera funds two police officers for the City of Marshall. Avera Marshall's Thrift Store impacts the community in a variety of ways. The store donated approximately 80,000 pounds of fiber to Advanced Opportunities. Advanced Opportunities then sells the fiber to help support their programs, which at current fiber rates would be approximately $64,000. The Thrift Store supports our judicial system by being an option for court ordered community service. The Thrift Store works with Project Turnabout to provide opportunities for those dealing with addiction to re-enter the workforce.
Part VI, Line 6:Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Julie Lautt
CFO Avera Health;Secretary/Treasurer$0$1,075,517$0$460$0$10,475$0$15,250$0$1,838$0$1,103,540$0$0
Emmy Ho MD
Orthopedics & Surgery$832,066$0$10,058$0$63,758$0$15,250$0$31,274$0$952,406$0$0$0
Daniel Lister MD
Orthopedics & Surgery$777,175$0$22,850$0$75,690$0$15,250$0$26,336$0$917,301$0$0$0
Arthur Rillo MD
Family Medicine/OB$565,374$0$111,508$0$59,029$0$15,250$0$31,310$0$782,471$0$0$0
Curtis Louwagie MD
Board Member/Opthalmology$652,728$0$38,347$0$4,482$0$15,250$0$37,966$0$748,773$0$0$0
Timothy Michals MD
Pediatrics & Internal Medicine$610,356$0$16,907$0$104,967$0$15,250$0$0$0$747,480$0$0$0
Jonna Maas MD
Internal Medicine & Hospitalist$390,169$0$261,571$0$32,279$0$15,250$0$30,147$0$729,416$0$0$0
Debbie Streier
Regional President & CEO$0$460,875$0$420$0$9,193$0$15,250$0$23,307$0$509,045$0$0
Doris Derynck
Former VP Clinical Operations/CNO$60,503$0$0$0$210,541$0$13,618$0$6,414$0$291,076$0$0$0
Sharon Williams
Former Sec/Treas & VP Finance$0$193,367$0$1,330$0$2,130$0$10,176$0$26,642$0$233,645$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4aDoris Derynck received a severance payment of $209,889 during FYE 06/30/2023.
Schedule J, Part I, Line 3:President/CEO serves Avera Marshall, Avera Tyler, and Avera Granite Falls and was compensated by a related organization, Avera Health. Avera Marshall relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Julie Lautt, Sharon Williams, Debbie Streier, and Sr Mary Jaeger have a business relationship. Julie Lautt, Stephen Crim and Debbie Streier have a business relationship.
Form 990, Part VI, Section A, line 6The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended.
Form 990, Part VI, Section A, line 7aAvera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the board of directors.
Form 990, Part VI, Section A, line 7bAvera Health, as the sole member, has the following rights as the member: 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of corporation; 2) To initiate the adoption, amendment or repeal of any provision of the articles of incorporation or bylaws of corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the member; 4) To approve any plan of merger, consolidation or dissolution of the corporation, or the divestiture of a sponsored work or ministry associated with the corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the corporation; 6) To appoint and remove, with or without cause, the board of directors of the corporation; 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the corporation; 8) To approve operating/capital budgets and strategic plans of the corporation; 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the member; 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the members; 11) To establish and maintain employee benefit programs; 12) To establish and maintain insurance programs; 13) To approve major community fund drives; 14) To approve the appointment of auditors; 15) To adopt policies designed to effectuate the reserved powers of the member.
Form 990, Part VI, Section A, line 8bThere are no committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members.
Form 990, Part VI, Section B, line 12cThe 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 15bThe CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.
Form 990, Part VI, Section C, line 19The organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 15,921,567. Management and general expenses 275,356. Fundraising expenses 0. Total expenses 16,196,923. Medical Professional Fees: Program service expenses 2,236,993. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,236,993. Repairs & Maintenance: Program service expenses 2,433,851. Management and general expenses 11,488. Fundraising expenses 0. Total expenses 2,445,339. Centralized Services: Program service expenses 4,830,902. Management and general expenses 6,424,421. Fundraising expenses 0. Total expenses 11,255,323.
Form 990, Part XI, line 9:Change in Interest in Avera Foundation 160,793.
Form 990, Part XII, Line 2c:The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements for Avera Health which includes Avera Marshall.
Form 990, Part X, Line 20:The issue price includes the filing organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg, and Avera at Home. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673.)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 West Avera Drive Suite 300Sioux FallsSD57108460422673Healthcare ServicesSD501(c)(3)Line 10N/A0
Avera McKennan
1325 S Cliff Ave PO Box 5045Sioux FallsSD57117460224743Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera at Home
5300 S Broadband LaneSioux FallsSD57108460399291Home ServicesSD501(c)(3)Line 100Avera Health
Avera Health Plans Inc
3900 West Avera Drive Suite 101Sioux FallsSD57108460451539Health Financing and Health Plan AdminSD501(c)(4)0Avera Health
Avera Granite Falls
345 10th AveGranite FallsMN56241843156881Healthcare ServicesMN501(c)(3)Line 3Yes (1)Avera Marshall
Avera Tyler
240 Willow StreetTylerMN56178410853163Healthcare ServicesMN501(c)(3)Line 3Yes (1)Avera Marshall
Avera Queen of Peace Hospital
525 North FosterMitchellSD57301460224604Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera St Anthony's Hospital
300 N 2nd StreetONeillNE68763470463911Healthcare ServicesNE501(c)(3)Line 30Avera Health
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera Gettysburg
606 East GarfieldGettsyburgSD57442460234354Healthcare ServicesSD501(c)(3)Line 30Avera St Mary's
Avera Holy Family
826 N 8th StreetEsthervilleIA51334420680370Healthcare ServicesIA501(c)(3)Line 30Avera Health
Holy Family Hospital Foundation
826 N 8th StreetEsthervilleIA51334421317452Support of Health Related ServicesIA501(c)(3)Line 100Avera Holy Family
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare ServicesSD501(c)(3)Line 30Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare ServicesSD501(c)(3)Line 100Avera Health
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare ServicesSD501(c)(3)Line 30Avera Health
St Benedict Health Center Foundation
West Glynn Drive PO Box BParkstonSD57366460226738Support of Health Related ServicesSD501(c)(3)Line 12a, I0St Benedict Health Center

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 Lincoln ST NELemarsIA51031820582350Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Lakes Regional Healthcare LLC
2301 Hwy 71 South Ste DSpirit LakeIA51360862949748Medical Services - Home Medical EquipmentIAN/A00
Avera Home Medical Equipment of Sioux Center LLC
38 19th St SWSioux CenterIA51250753203100Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota AveSioux FallsSD57117800619999Medical Services - Home Medical EquipmentSDN/A00
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101BrookingsSD57006453204123Medical services - Home Medical EquipmentSDN/A00
Caravan Health ACO 15 LLC dba Prairie Vista Care Organization
7509 NW Tiffany Springs Parkway SteKansas CityMO64153611843657Accountable Care OrganizationMON/A00
Caravan Health ACO 41 LLC dba Prairie View Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153821447782Accountable Care OrganizationMON/A00
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare ServicesSDN/A00
Surgical Associates Endoscopy Clinic LLC
310 S PennsylvaniaAberdeenSD57401460461429Surgical AssociatesSDN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Accounts Management Inc
5132 S Cliff Ave Suite 101Sioux FallsSD57108460373021Collection AgencySDN/AC0
Alucent Australia Pty Ltd
Biotech researchN/A0Level 10 30 Collings StreetMelbourneVIC 3000ASAS
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045Sioux FallsSD571175045471818349Biotech researchSDN/AC0
Avera Property Insurance Inc
1000 West 4th Street Suite 1YanktonSD57078460463155InsuranceSDN/AC0
DakotaCare Administrative Services Inc
5300 South Broadband LaneSioux FallsSD57108460424322InsuranceSDN/AC0
Kore Cares in Home Services LLC
5300 South Broadband LaneSioux FallsSD57108882278902In-home care servicesSDN/AS0
South Dakota State Medical Holding Company Inc
5300 South Broadband LaneSioux FallsSD57108460401087InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental real estateSDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other OrgYes (1)AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera Tyler
L$1,034,366General Ledger
Avera Granite Falls
L$1,864,725General Ledger
Avera Tyler
O$1,636,156General Ledger
Avera Granite Falls
O$3,451,066General Ledger
Avera Tyler
Q$91,331General Ledger
Avera Granite Falls
Q$285,086General Ledger
Avera Tyler
R$69,088General Ledger
Avera Granite Falls
R$162,717General Ledger

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule R, Part IIFormAndLineReferenceDesc
ExplanationSt. Benedict Health Center Foundation dissolved as of December 31, 2022.ExplanationTxt