AVERA TYLER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- AVERA TYLER (EIN 41-0853163)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202121379349305457
- Schema version
- 2019v5.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T13:19:44-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410853163 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Tyler | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 5072475521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 Willow Street | AddressLine1Txt |
| City | Tyler | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56178 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 5072475521 | PhoneNum |
| Signature | 2021-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2021-05-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Debbie Streier | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 Willow Street | AddressLine1Txt |
| City | Tyler | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56178 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,124,436 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.avera.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1918 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 143 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $26,652 | PYContributionsGrantsAmt |
| CY Contributions Grants | $926,499 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,775,621 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,139,147 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,743 | PYInvestmentIncomeAmt |
| CY Investment Income | $57,067 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,114 | PYOtherRevenueAmt |
| CY Other Revenue | $1,723 | CYOtherRevenueAmt |
| PY Total Revenue | $11,807,130 | PYTotalRevenueAmt |
| CY Total Revenue | $12,124,436 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $22,069 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,648,914 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,338,505 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $6,203 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,269,372 | PYOtherExpensesAmt |
| CY Other Expenses | $4,877,799 | CYOtherExpensesAmt |
| PY Total Expenses | $10,918,286 | PYTotalExpensesAmt |
| CY Total Expenses | $11,238,373 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $888,844 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $886,063 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,149,682 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,515,698 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,120,668 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,374,053 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,029,014 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,141,645 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Avera Health is a ministry rooted in the gospel. Our mission is to make a postive impact in the lives and health of persons and communities by providing quality services guided by Christian values. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,445,058 | ExpenseAmt |
| Grant | $22,069 | GrantAmt |
| Revenue | $11,140,870 | RevenueAmt |
| Desc | Avera Tyler's mission is to provide healthcare services to Tyler, Minnesota residents and residents of the surrounding counties including Lincoln, Pipestone and Lyon. Avera Tyler is a 501(c)(3) organization affiliated with Avera Health and controlled by Avera Marshall. Avera Tyler consists of a 21-bed hospital, a Rural Health Clinic and a 30-bed nursing home in Tyler, Minnesota, a Rural Health Clinic in Lake Benton, Minnesota and a Rural Health Clinic in Ivanhoe, Minnesota. The program services offered include primary care, general surgery, infusion, radiology, nuclear medicine, ultrasound, chemotherapy, cardiac rehab, speech therapy, physical therapy and occupational therapy. Avera Tyler provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera Tyler Hospital:83 Acute patient discharges25 Swing Bed patient discharges8 Long Term Care patient discharges5,513 Outpatient visits277 Swing-bed patient days6,170 Clinic visits - Tyler1,166 Clinic visits - Lake Benton549 Clinic visits - IvanhoeSunrise Manor10,766 Long-term resident daysAvera Tyler 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 $26,070.Avera Tyler 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 Tyler 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 Tyler 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 | $9,445,058 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 143 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jamie Schaefer | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6053223992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3900 W Avera Dr Ste 300 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 41.30 | Yes (X) | $0 | $1,018,166 | $36,856 | ||
| Curtis Louwagie MD | ||||||||
| Director/Ophthlalmologist | 1.30 | 41.30 | $0 | $759,379 | $48,258 | Yes (X) | ||
| Julie Lautt - Joined 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 40.70 | Yes (X) | $0 | $518,454 | $35,583 | ||
| Mary Maertens | ||||||||
| President/CEO Avera Marshall | 1.30 | 42.30 | Yes (X) | $0 | $452,406 | $41,358 | Yes (X) | |
| Sharon Williams | ||||||||
| Former VP Finance | 0.10 | 40.00 | $0 | $182,151 | $34,817 | Yes (X) | ||
| Allen AndersonAdministrator | ||||||||
| Former Officer | 40.00 | 0.00 | $0 | $143,868 | $25,106 | Yes (X) | ||
| Stephen Crim | ||||||||
| Director | 1.30 | 1.30 | $0 | $17,395 | $0 | Yes (X) | ||
| Joyce Strootman | ||||||||
| Chair | 1.30 | 1.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Doug Olsem | ||||||||
| Vice Chair | 1.30 | 1.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Sr Roxanne Seifert | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Sr Jodie Zimmerman | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Quentin Fixen | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Laurie Johansen | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| George Jorgensen | ||||||||
| Director | 1.30 | 2.30 | $0 | $0 | $0 | Yes (X) | ||
| Randy Serreyn | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Todd Bock | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Amanda Sieling | ||||||||
| Director | 1.30 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,091,819 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $221,978 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Marshall | |||||
| 300 South Bruce St | Marshall | MN | 56258 | Physicians and Shared Services | $944,917 |
| Big Stone Therapies Inc | |||||
| 500 Cross St | Big Stone City | MN | 57216 | PT,OT, and Speech Therapy | $575,876 |
| Avera McKennan | |||||
| 800 E 21st St | Sioux Falls | SD | 57117 | Physicians, Lab, Radiology, and Other Cl | $180,017 |
| Avera Health | |||||
| 3900 W Avera Dr | Sioux Falls | SD | 57108 | Shared Services | $113,560 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,135 | RelatedOrganizationsAmt |
| Government Grants | $911,187 | GovernmentGrantsAmt |
| All Other Contributions | $3,177 | AllOtherContributionsAmt |
| Noncash Contributions | $12,135 | NoncashContributionsAmt |
| Total Contributions | $926,499 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 622110 | $10,959,846 | $10,959,846 |
| Pharmacy Revenue | 900099 | $129,728 | $129,728 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,573 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,573 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,139,147 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,617 | TotalRevenueColumnAmt |
| Exclusion | $1,617 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $55,450 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $55,450 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,450 | TotalRevenueColumnAmt |
| Exclusion | $55,450 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | A/R Interest Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,723 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,723 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,723 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,124,436 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,140,870 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $57,067 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,069 | TotalAmt |
| Program Services | $22,069 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,963,641 | TotalAmt |
| Program Services | $4,700,518 | ProgramServicesAmt |
| Management And General | $263,123 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,226 | TotalAmt |
| Program Services | $226,823 | ProgramServicesAmt |
| Management And General | $17,403 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $792,876 | TotalAmt |
| Program Services | $742,565 | ProgramServicesAmt |
| Management And General | $50,311 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,762 | TotalAmt |
| Program Services | $317,213 | ProgramServicesAmt |
| Management And General | $20,549 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,250 | TotalAmt |
| Program Services | $5,250 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93 | TotalAmt |
| Management And General | $93 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,775,674 | TotalAmt |
| Program Services | $1,673,475 | ProgramServicesAmt |
| Management And General | $1,096,199 | ManagementAndGeneralAmt |
| Fundraising | $6,000 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $756 | TotalAmt |
| Program Services | $178 | ProgramServicesAmt |
| Management And General | $578 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,476 | TotalAmt |
| Program Services | $100,327 | ProgramServicesAmt |
| Management And General | $50,946 | ManagementAndGeneralAmt |
| Fundraising | $203 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,662 | TotalAmt |
| Program Services | $8,984 | ProgramServicesAmt |
| Management And General | $52,678 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,986 | TotalAmt |
| Program Services | $186,660 | ProgramServicesAmt |
| Management And General | $74,326 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,589 | TotalAmt |
| Program Services | $35,698 | ProgramServicesAmt |
| Management And General | $4,891 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,232 | TotalAmt |
| Program Services | $34,232 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,083 | TotalAmt |
| Program Services | $1,083 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,313 | TotalAmt |
| Program Services | $238,662 | ProgramServicesAmt |
| Management And General | $40,651 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,025 | TotalAmt |
| Program Services | $19,025 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $918,524 | $917,884 | $640 |
| Equipment Lease/Rental | $64,484 | $64,484 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,652 | TotalAmt |
| Program Services | $149,928 | ProgramServicesAmt |
| Management And General | $114,724 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,238,373 | TotalAmt |
| Program Services | $9,445,058 | ProgramServicesAmt |
| Management And General | $1,787,112 | ManagementAndGeneralAmt |
| Fundraising | $6,203 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,583 | BOYAmt |
| EOY | $536,093 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,217,402 | BOYAmt |
| EOY | $1,229,003 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $214,752 | BOYAmt |
| EOY | $264,311 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,667 | BOYAmt |
| EOY | $41,599 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,953,117 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,689,074 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,370,980 | BOYAmt |
| EOY | $1,264,043 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,267,298 | BOYAmt |
| EOY | $10,092,463 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $88,186 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,149,682 | BOYAmt |
| EOY | $13,515,698 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $639,179 | BOYAmt |
| EOY | $733,946 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,264,371 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,282 | BOYAmt |
| EOY | $102,830 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $345,207 | BOYAmt |
| EOY | $3,272,906 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,120,668 | BOYAmt |
| EOY | $7,374,053 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,468,485 | BOYAmt |
| EOY | $5,535,003 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,529 | BOYAmt |
| EOY | $606,642 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,029,014 | BOYAmt |
| EOY | $6,141,645 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,149,682 | BOYAmt |
| EOY | $13,515,698 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $886,063 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $43,174 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $183,394 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $93 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $93 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Avera Tyler paid dues to organizations which have a portion of the dues attributed to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $157,440 | OtherCostOrOtherBasisAmt |
| Book Value | $157,440 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,007,783 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,423,985 | DepreciationAmt |
| Book Value | $583,798 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,343 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,390 | DepreciationAmt |
| Book Value | $6,953 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,677,213 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,206,241 | DepreciationAmt |
| Book Value | $470,972 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $97,338 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,458 | DepreciationAmt |
| Book Value | $44,880 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,264,043 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Pooled Investments | $9,446,902 | F |
| Investment in Avera Health Foundation | $645,561 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $10,092,463 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Third Party Payor Settlements | $78,313 |
| Right of Use Operating Lease Obligations | $91,900 |
| Deferred Payroll Taxes | $66,425 |
| Intercompany Payables | $1,813,554 |
| Contract Liability - Medicare Advanced Payments | $1,222,714 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,272,906 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,299 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,299 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,555,448 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,415,682 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $139,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,579,747 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,415,682 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $164,065 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,800 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,135 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,665 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,876 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,876 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,445,709 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,368,098 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,077,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18490 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $123,352 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $123,352 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,577,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,370,233 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,207,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19650 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,157,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,785,915 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,371,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.21110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $193,810 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,427,673 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,433,912 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,239 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Tyler | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 Willow St | AddressLine1Txt |
| City | Tyler | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56178 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.avera.org/locations/profil | WebsiteAddressTxt |
| State License | 371548 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 3 rural health clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera Tyler | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Page 8 | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Part V, Page 8 | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | see Part V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | see Part V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | see Part V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Avera Tyler | Part V, Section B, Line 5: The Avera Tyler 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 and a community forum. In addition, Avera Tyler 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. |
| Avera Tyler | Part V, Section B, Line 6b: Southwest Health and Human Services |
| Avera Tyler | Part V, Section B, Line 11: The community health needs assessment was completed in 2018. The three priorities identified were Mental Health, Obesity/Diabetes and Tobacco and e-cigarette use and exposure. Avera Tyler will take steps to address the identified needs.Mental Health * Increase the proportion of adults and children with mental health disorders who receive treatment. Improve behavioral health (BH) access and quality care. Increase appropriate use of screening and prevention services. * Increase awareness and reduce stigma around mental health issues and assist in disbursing local resource materials. Increase involvement with National Alliance on Mental Illness of Minnesota (NAMI).* Tap into depression resources * Provide employees with a depression screening tool * Provide and enhance utilization of employee assistance program (EAP) resources * Provide better adherence to medical care for those with behavioral health (BH) conditions measured by percentage of patients receiving BH screening and percentage of patients discharged with a BH referral. * Continue to operate mental health services, including inpatient and outpatient psychiatric programs. Partner with mental health providers to offer education on stress management to our patients and the community. * Further integrate mental health services into Primary Care. Monitor and improve collaborative opportunities between medical and behavioral health care. * Position Avera Marshall Behavioral Health as a Center of Excellence for the practice of Dialectical Behavior Therapy (DBT) as a champion for the Zero Suicide initiativeFY2020 update: Due to the Covid pandemic, Avera Tyler did not address all the identified goals in the 2019 CHNA. The inability to gather in groups prohibited planning meetings. Virtual meetings were not readily available until the latter part of 2020. Avera Tyler did form a relationship with Western Mental Health by providing clinic accessibility in August 2020.Obesity/Diabetes* Continue to collaborate with partner agencies to assist community members in obtaining needed nutritional information. * Explore potentialities in developing healthy eating and exercise programs to be promoted via affected communities' chambers of commerce and religious organizations. * Promote Obesity screening and counseling * Promote Healthy diet and physical activity * Provide hospital classes with Nutrition Services and Dieticians to cook healthier * Provide Weight loss Programs * Provide Wellness Coaches * Facility will provide meeting support * Continue working on strategies related to overall BMI improvement * Continue Education and screenings at health fairs and educational events* Distribute information on community resources such as free meals and food pantries * Support community support groups by providing meeting space, speakers, and educational topics FY 2020 Update: Due to the Covid pandemic, Avera Tyler did not get to act on the majority of their Obesity/Diabetes actions. They did start community cooking classes but the classes were discontinued following the onset of the pandemic. Avera Tyler anticipates initiating and resuming actions to address the identified community needs.Tobacco and e-cigarette use and exposure* Emphasize communication and education on the health risks associated with tobacco and e-cigarette use (vaping) and exposure. * Initiate, promote and enforce smoking/vaping free policies on healthcare facilities grounds and promote asking partnering suppliers and onsite vendors to do the same.* Continue current and expand hospital prevention classes* Facility will provide Tobacco Cessation Programs and meeting support* Employees will participate in community education to promote the prevention of smokingFY2020 Update: The Covid pandemic impacted the ability to meet in person. Avera Tyler did not initiate any of the actions proposed under the Tobacco and e-cigarette use and exposure in FY2020. Avera Tyler anticipates initiating actions to address the identified community needs.The following health needs/priorities will not be directly addressed by Avera Tyler due to capability to address by other community organizations:* Cardiovascular disease* Asthma* CancerMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. |
| Avera Tyler | Part 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 Tyler | Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Avera Tyler | Part 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 Tyler | Part 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. |
| Schedule H, Part V, Section B, Line 7a and 7b: | https://www.avera.org/about/community-health-needs-assessments/ |
| Schedule H, Part V, Section B, Line 10a: | https://www.avera.org/about/community-health-needs-assessments/ |
| Schedule H, Part V, Section B, Lines 16a, 16b, and 16c: | https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Avera Sunrise Manor | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 Willow St | AddressLine1Txt |
| City | Tyler | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56178 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Skilled nursing facility | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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: | Rural health clinic costs are included in subsidized health services. Revenues of $1,001,824 and costs of $2,393,909 were included for a net community benefit of $1,392,085. |
| Part II, Community Building Activities: | The organization provided support for the Tyler Safe, Walkable Community Task Force. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 17 and 18. |
| Part III, Line 8: | Avera Tyler provides services to patients under the Medicare program knowing they will 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, 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: | In addition to the CHNA, Avera Tyler identifies the needs of the community by providing topical and seasonal lectures within the community, performing outreach to other organizations (i.e. the high school), utilizing patient surveys, attending community events and stakeholder events to determine specific needs, and by having the professional medical staff determine needs based on their daily interactions with the community. |
| Part VI, Line 3: | Anyone who is uninsured receives a letter with their itemized bill which describes both the uninsured program and the financial assistance program. Any uninsured patient is contacted by phone or letter by a patient advocate at which time the programs are described. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the charity care and uninsured programs. |
| Part VI, Line 4: | Avera Tyler is a 21-bed critical access hospital in Tyler, Minnesota. The primary service area is defined as Lincoln County, Minnesota, including the communities of Arco, Hendricks, Ivanhoe, Lake Benton and Tyler. Ivanhoe is the county seat. According to the U.S. Census Bureau Quick Facts 2019 data, the estimated population of Lincoln County as of July 1, 2019 is 5,639 and is predominately white at 97.4%. It is estimated that 25.1% of the population is 65 years and over. The median household income is $53,077 with a 10.1% poverty rate. Uninsured individuals under age 65 is estimated at 6.3%. |
| Part VI, Line 5: | The organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. Charity care is available for those with a diminished ability to pay. As a result of the mission statement, Avera Tyler provides numerous services which do not produce a profit. Examples are ambulance services and a 24/7 fully staffed emergency department.Avera Tyler is very involved in the community. Avera Tyler's leadership team is encouraged to participate in civic and community organizations. The leadership team is involved in the Tyler Area Community Club which sponsors events in the community such as "Band Shell Bazaar" which occurs on Wednesday evenings in August. This includes music entertainment, games for kids and includes a farmers market. Annually Avera Tyler has a hospice benefit. The proceeds are used to care for hospice patients and their families. Avera Tyler is also involved in the annual community celebration Aebleskiver Days which includes a parade. A booth for Avera Tyler at the Lincoln County Fair provides water to annual fair attendees. Several support groups which include Caregivers Support Groups and Powerful Tools for Caregivers are sponsored at Avera Tyler. Avera Medical Group Tyler and Lake Benton providers provide many educational sessions for the Tyler community. Additionally health screens are provided free of charge by the Avera Medical Group staff.Avera Tyler uses financial opportunities to further the technology used at the hospital in order to better serve their patients. |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $945,274 | $0 | $1,760 | $0 | $71,132 | $0 | $14,000 | $0 | $22,856 | $0 | $1,055,022 | $0 | $0 |
| Curtis Louwagie MD | ||||||||||||||
| Director/Ophthlalmologist | $0 | $690,253 | $0 | $65,009 | $0 | $4,117 | $0 | $14,000 | $0 | $34,258 | $0 | $807,637 | $0 | $0 |
| Julie Lautt - Joined 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $516,081 | $0 | $400 | $0 | $1,973 | $0 | $14,000 | $0 | $21,583 | $0 | $554,037 | $0 | $0 |
| Mary Maertens | ||||||||||||||
| President/CEO Avera Marshall | $0 | $440,845 | $0 | $930 | $0 | $10,631 | $0 | $14,000 | $0 | $27,358 | $0 | $493,764 | $0 | $0 |
| Sharon Williams | ||||||||||||||
| Former VP Finance | $0 | $179,109 | $0 | $1,225 | $0 | $1,817 | $0 | $9,481 | $0 | $25,336 | $0 | $216,968 | $0 | $0 |
| Allen AndersonAdministrator | ||||||||||||||
| Former Officer | $0 | $143,527 | $0 | $0 | $0 | $341 | $0 | $7,394 | $0 | $17,712 | $0 | $168,974 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The President/CEO serves Avera Marshall, Avera Tyler, and Avera Granite Falls and was compensated by a related organization, Avera Health. Avera Tyler relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | The Executive Committee is subject to the direction of the Board of Directors. However, in the case of an emergency, the Executive Committee may exercise all the powers of the board provided that any actions taken shall be reported to the board as quickly as possible. The Chair, Vice-Chair, and Past Chair will make up the composition of the Executive Committee. The President/CEO will serve as a non-voting, ex-officio member of the Executive Committee. |
| Form 990, Part VI, Section A, line 2 | Jim Breckenridge, Julie Lautt, Mary Maertens and Sharon Williams have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the Corporation is Avera Marshall, a nonprofit corporation organized and existing under the laws of the State of Minnesota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Marshall as the sole member, has the power to appoint and remove, with or without cause, members of the board of directors. |
| Form 990, Part VI, Section A, line 7b | Avera Marshall, the Member, has the exclusive right: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; (b) 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; (c) To appoint and remove, with or without cause, the Board of Directors of the Corporation. (d) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. (e) To approve operating/capital budgets and strategic plans of the Corporation. (f) 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. (g) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. (h) To establish and maintain employee benefit programs. (i) To establish and maintain insurance programs. (j) To approve major community fund drives. (k) To approve the appointment of auditors. (l) To adopt policies designed to effectuate the reserved powers of the Member. (m) To initiate and give final approval to equity and asset transfers by and between the Member and the Corporation and any affiliates or subsidiaries of the Member. (n) To initiate and give final approval to (i) any and all issuances of obligations under any existing or future master indentures binding the Corporation, any indebtedness (including, without limitation, capitalized leases) in excess of dollar thresholds as may be from time to time established by the Member, and (ii) any pledges of collateral for such indebtedness and any pledges of real estate as collateral for any indebtedness regardless of amount. (o) (i) Full and exclusive power to execute supplemental master indentures, including, without limitation, those authorizing the issuance of obligations or series of obligations, (ii) full and exclusive power to prepare, or authorize the preparation of, any and all documents, agreements, swap agreements, investment contracts, certificates and disclosure materials (including, without limitation, Official Statements and any supplements thereto) reasonably and ordinarily prepared in connection with the issuance of obligations thereunder, or related bonds associated therewith and to execute and deliver such items to the appropriate parties in connection therewith and (iii) full and exclusive power to authorize the entrance of members to, or withdrawal of members from, any obligated group, subject to the other requirements of the applicable master indenture for such entrance or withdrawal. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is reviewed by the Avera Health VP of Financial Reporting, Tax Manager, Facility CEO and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. |
| Form 990, Part VI, Section B, line 15 | The 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 19 | The 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 11g | Purchased Services: Program service expenses 1,380,641. Management and general expenses 73,485. Fundraising expenses 6,000. Total expenses 1,460,126. Medical Prof Fees: Program service expenses 3,476. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,476. Repairs and Maintenance: Program service expenses 289,358. Management and general expenses 33,062. Fundraising expenses 0. Total expenses 322,420. Centralized Services: Program service expenses 0. Management and general expenses 989,652. Fundraising expenses 0. Total expenses 989,652. |
| Form 990, Part XI, line 9: | Equity Transfers 139,645. Change in Interest in Avera Foundation 43,749. |
| 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 Tyler. |
| Form 990, Part X, Line 20: | Avera Tyler is part of the Avera Obligated Group which 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. Avera Tyler was not allocated any share of the bond issue, and thus does not have an amount on line 20. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | ||||||||||
| 3900 West Avera Drive Ste 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of Health | SD | 501(c)(3) | Line 10 | 0 | |
| Avera St Anthony's Hospital | ||||||||||
| 300 N 2nd Street | ONeill | NE | 68763 | 470463911 | Healthcare services | NE | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Holy Family | ||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare services | IA | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Holy Family Foundation | ||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support health related services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family |
| St Benedict Health Center | ||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| St Benedict Health Center Foundation | ||||||||||
| West Glynn Drive PO Box B | Parkston | SD | 57366 | 460458725 | Support health related services | SD | 501(c)(3) | Line 12a, I | 0 | St Benedict Health Center |
| Avera McKennan | ||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460224743 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Queen of Peace Hospital | ||||||||||
| 525 North Foster | Mitchell | SD | 57301 | 460224604 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| Sacred Heart Health Services | ||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Gettysburg | ||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's |
| Avera at Home | ||||||||||
| 5116 S Solberg Ave | Sioux Falls | SD | 57108 | 460399291 | Home services | SD | 501(c)(3) | Line 10 | 0 | Avera Health |
| Lewis and Clark Health Education and Service Agency | ||||||||||
| 1000 W 4th Street Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare education | SD | 501(c)(3) | Line 10 | 0 | Sacred Heart Health Services |
| Avera St Luke's | ||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera St Mary's | ||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Marshall | ||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 410919153 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Health |
| Avera Health Plans Inc | ||||||||||
| 3900 West Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health financing and health plan admin | SD | 501(c)(4) | 0 | Avera Health | |
| Avera Granite Falls | ||||||||||
| 345 10th Ave | Granite Falls | MN | 56241 | 843156881 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | |||||||
| 714 Lincoln St NE | Lemars | IA | 51031 | 820582350 | Medical services - home medical equipment | SD | N/A |
| Avera Home Medical Equipment of Sioux Center LLC | |||||||
| 38 19th St SW | Sioux Center | IA | 51250 | 753203100 | Medical services - home medical equipment | SD | N/A |
| Q&M Properties LLC | |||||||
| 525 North Foster | Mitchell | SD | 57301 | 731652049 | Medical clinic building | SD | N/A |
| Surgical Associates Endoscopy Clinic LLC | |||||||
| 310 S Penn | Aberdeen | SD | 57401 | 460461429 | Surgical associates | SD | N/A |
| Avera Home Medical Equipment of Spencer Hospital LLC | |||||||
| 2400 S Minnesota Ave | Sioux Falls | SD | 57117 | 800619999 | Medical Services - home medical equipment | SD | N/A |
| Heart Hospital of South Dakota LLC | |||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare Services | SD | N/A |
| Brookings Health System - Avera HME LLC | |||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Healthcare Services | SD | N/A |
| National Rural ACO 4 LLC dba Prairie Hills Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 371780735 | Accountable Care Organization | KS | N/A |
| National Rural ACO 5 LLC dba Great Plains Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 383958290 | Accountable Care Organization | KS | N/A |
| Caravan Health ACO 41 LLC dba Prairie View Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 821447782 | Accountable Care Organization | KS | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | |||||||||
| 5132 S Cliff Ave Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection agency | SD | N/A | C | 0 |
| Avera Property Insurance Inc | |||||||||
| 1000 West 4th Street Suite 1 | Yankton | SD | 57078 | 460463155 | Insurance | SD | N/A | C | 0 |
| Valley Health Services | |||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | Rental Real Estate | SD | N/A | C | 0 |
| Alucent Medical Inc | |||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | Biotech Research | SD | N/A | C | 0 |
| South Dakota State Medical Holding Company Inc | |||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460401087 | Insurance | SD | N/A | C | 0 |
| DakotaCare Administrative Services Inc | |||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460424322 | Insurance | SD | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |