2020-05-26T11:57:46-05:00 2019-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-07-01 410853163 Avera Tyler AVER 5072475521 240 Willow Street Tyler MN 56178 Julie Norton CFO Avera Health 5072475521 2020-05-11 1 Kim Hunwardsen CPA P00484560 6122536500 2020-05-11 216.147.181.49 2020-05-11 10:32:47 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC EFC25E59FA7409AE560978A003AFB9E955B778C6 2018 2020-09-23 17:36:50Z Mary Maertens 240 Willow Street Tyler MN 56178 11807130 0 X www.avera.org X 1918 MN Promotion of health 13 11 124 40 0 0 18671 26652 11317407 11775621 14978 3743 2720 1114 11353776 11807130 0 0 0 0 4206711 4648914 0 0 0 6609504 6269372 10816215 10918286 537561 888844 5430571 6149682 1183271 1120668 4247300 5029014 X 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. 0 0 9440372 11776735 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, of which there were 176 patient discharges, 10,282 outpatient visits, 325 swing-bed days, 9,245 clinic visits, and 9,583 nursing home resident days. Following is a breakdown of these statistics by facility:Avera Tyler Hospital113 Acute patient discharges34 Swing Bed patient discharges29 Long Term Care patient discharges10,282 Outpatient visits325 Swing-bed patient days6,980 Clinic visits - Tyler1,480 Clinic visits - Lake Benton785 Clinic visits - IvanhoeSunrise Manor9,583 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 $61,240.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. 9440372 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 17 0 1 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Joyce Strootman Chair 1.30 1.30 X X 0 0 0 Doug Olsem Vice Chair 1.30 1.30 X X 0 0 0 Todd Bock Director 1.30 1.30 X 0 0 0 Quentin Fixen Director 1.30 1.30 X 0 0 0 Laurie Johansen Director 1.30 1.30 X 0 0 0 George Jorgensen Director 1.30 1.30 X 0 0 0 Sr Roxanne Seifert Director 1.30 41.30 X 0 0 0 Randy Serreyn Director 1.30 1.30 X 0 0 0 Sr Kathleen Bierne Director 1.30 2.30 X 0 0 0 Curtis Louwagie MD Director/Ophthlalmologist 1.30 41.30 X 0 868838 45120 Sr Jodie Zimmerman Director 1.30 1.30 X 0 0 0 Amanda Sieling Director 1.30 1.30 X 0 0 0 Mary Maertensex-officio wvote President/CEO Avera Marshall 2.50 40.00 X X 0 418366 44004 Jim Breckenridge CFO Avera Health; Sec/Treas 0.10 39.90 X 0 918859 34586 Sharon Williams Former VP Finance 0.10 40.00 X 0 176682 33779 Allen AndersonAdministrator Former Officer 40.00 0.00 X 0 138360 25359 0 2521105 182848 0 1 1 0 Avera Marshall 300 South Bruce St Marshall MN 56258 Physicians and Shared Services 2871342 Big Stone Therapies Inc 309 Washington Ave Ortonville MN 56278 PT,OT, and Speech Therapy 649315 Avera McKennan 800 E 21st St Sioux Falls SD 57117 Physicians, Lab, Radiology, and Other Cl 168394 Avera Health 3900 W Avera Dr Sioux Falls SD 57108 Shared Services 115620 4 5531 21121 26652 Patient Service Revenue 622110 11580666 11580666 Pharmacy Revenue 900099 129273 129273 65682 65682 11775621 3743 3743 A/R Interest Income 900099 1114 1114 1114 11807130 11776735 0 3743 X 3394249 3081256 312993 192890 185542 7348 819263 785280 33983 242512 227877 14635 5710 5710 163 163 3225742 2521873 703869 216 216 86410 66737 19673 50312 50312 279841 279841 50935 43202 7733 3052 3052 1604 1604 532220 327208 205012 76836 76836 Medical Supplies 944997 944997 Repairs and Maintenance 428422 379292 49130 Bad Debt Expense 207414 207414 Licenses and Permits 3371 3371 372127 254678 117449 10918286 9440372 1477914 0 1754713 26583 913374 1217402 217612 214752 69337 52667 7786623 6415643 1798534 1370980 673634 3267298 3367 0 5430571 6149682 588365 639179 5818 190168 136282 398920 345207 1183271 1120668 X 3819319 4468485 220213 352761 207768 207768 4247300 5029014 5430571 6149682 X 888844 49386 -156516 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 163 163 0 Part II-B, Line 1: Avera Tyler paid dues to organizations which have a portion of the dues attributed to lobbying activities. 157440 157440 1986371 1262440 723931 14557 5474 9083 5543052 5039251 503801 85203 108478 -23275 1370980 Pooled Investments 2670887 F Investment in Avera Health Foundation 596411 F 3267298 Third Party Payor Settlements 345207 345207 X 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. 1 1 X 1 X 1 X 1 1 1 0 0 28220 28220 0.00260 1795379 1598457 196922 0.01840 1823599 1598457 225142 0.02100 7554 870 6684 0.00060 4371 4371 0.00040 3371406 1688995 1682411 0.15710 129845 129845 0.01210 3513176 1689865 1823311 0.17020 5336775 3288322 2048453 0.19120 696 696 0.00010 696 696 0.00010 1 207414 0 2669515 2681029 -11514 X 1 1 1 1 Avera Tyler 240 Willow St Tyler MN 56178 https://www.avera.org/locations/profil 371548 X X X X 3 rural health clinics Avera Tyler 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X See Part V, Page 8 X See Part V, Page 8 X 1 18 1 See Part V, Page 8 0 1 X 150.000000000000 400.000000000000 X X X X 1 1 X X X 1 X see Part V X see Part V X see Part V X X X X X X X 1 X 0 X X X X X 1 X 0 0 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 during the tax year and as such the hospital has not taken specific actions with respect to the current implementation strategy. The following community health areas were identified and the following actions will be taken by the hospital during future years.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 % of patients receiving BH screening and % 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 initiativeObesity/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 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 smokingThe 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/ 1 1 - Avera Sunrise Manor 240 Willow St Tyler MN 56178 Skilled nursing facility 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 $941,661 and costs of $2,016,697 were included for a net community benefit of $1,075,035. Part I, Ln 7 Col(f): Bad debt expense of $207,414 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage. Part II, Community Building Activities: The organization provided support for the Tyler Safe, Walkable Community Task Force. Part III, Line 2: Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year.Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: Avera Tyler has several procedures in place to determine which patients would qualify for financial assistance, therefore the hospital feels confident that no amount of bad debt expense is attributable to patients eligible under the Organization's financial assistance policy. Part III, Line 4: The footnote to the Organization's financial statements that describes bad debt expenses can be found on page 11 of the attached audited financial statements. 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 provides services to a community of about 6,000 people in Lincoln, Lyon, Murray, and Pipestone Counties. Lincoln County is considered to be the primary service area. A large portion of the population is over 65 years of age and is predominately white and English speaking. 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. 0 0 0 0 0 0 0 0 0 Curtis Louwagie MD Director/Ophthlalmologist 0 656826 0 210000 0 2012 0 13750 0 31370 0 913958 0 0 Mary Maertensex-officio wvote President/CEO Avera Marshall 0 340581 0 900 0 76885 0 13750 0 30254 0 462370 0 0 Jim Breckenridge CFO Avera Health; Sec/Treas 0 693359 0 1720 0 223780 0 13750 0 20836 0 953445 0 0 Sharon Williams Former VP Finance 0 174063 0 1020 0 1599 0 9181 0 24599 0 210462 0 0 Allen AndersonAdministrator Former Officer 0 138106 0 0 0 254 0 7130 0 18230 0 163720 0 0 Schedule J, Part I, Line 3: The President/CEO serves both Avera Marshall and Avera Tyler 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. 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 and Mary Maertens 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 Other Fees: Program service expenses 2,521,873. Management and general expenses 158,344. Fundraising expenses 0. Total expenses 2,680,217. ACS Fees: Program service expenses 0. Management and general expenses 545,525. Fundraising expenses 0. Total expenses 545,525. Form 990, Part XI, line 9: Transfer to related party -230,926. Change in Interest in Avera Foundation 74,410. 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 Gettysburg and Avera at Home. Avery Tyler was not allocated any share of the bond issue, and thus does not have an amount on line 20. 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 Avera Health 0 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 0 Avera Holy Family Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 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 St Benedict Health Center 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Queen of Peace Hospital 525 North Foster Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera at Home 5116 S Solberg Ave Sioux Falls SD 57108 460399291 Home services SD 501(c)(3) Line 10 Avera Health 0 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 Sacred Heart Health Services 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 0 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 0 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) Avera Health 0 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 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 610 W 23rd St PO Box 38 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 2600 W 49th Street Sioux Falls SD 57105 460401087 Insurance SD N/A C 0 DakotaCare Administrative Services Inc 2600 W 49th Street Sioux Falls SD 57105 460424322 Insurance SD N/A C 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1