FURP.ORG / PUBLIC DATA EXPLORER

AVERA TYLER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
AVERA TYLER (EIN 41-0853163)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-14
IRS object ID
201901349349308370
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-14T15:28:19-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410853163EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera TylerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone5072475521PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 Willow StreetAddressLine1Txt
CityTylerCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56178ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJim BreckenridgePersonNm
Person TitleCFO Avera HealthPersonTitleTxt
Phone5072475521PhoneNum
Signature2019-05-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2019-05-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address8.39.233.107IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-10IPDt
IP Tm14:38:15IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD8A1E5117AA53286D53F57459EBB2DE5C7CA50FCAtSubmissionCreationDeviceId
At Submission Filing Device IdF9BEE9501A3B4F00F190E63700B8BF2BC70C7B96AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMary MaertensPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 Willow StreetAddressLine1Txt
CityTylerCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56178ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,353,776GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.avera.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1918FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPromotion of healthActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee151TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$176,278PYContributionsGrantsAmt
CY Contributions Grants$18,671CYContributionsGrantsAmt
PY Program Service Revenue$10,759,073PYProgramServiceRevenueAmt
CY Program Service Revenue$11,317,407CYProgramServiceRevenueAmt
PY Investment Income$38,636PYInvestmentIncomeAmt
CY Investment Income$14,978CYInvestmentIncomeAmt
PY Other Revenue$252,678PYOtherRevenueAmt
CY Other Revenue$2,720CYOtherRevenueAmt
PY Total Revenue$11,226,665PYTotalRevenueAmt
CY Total Revenue$11,353,776CYTotalRevenueAmt
PY Grants And Similar Paid$1,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,152,126PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,206,711CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,494,640PYOtherExpensesAmt
CY Other Expenses$6,609,504CYOtherExpensesAmt
PY Total Expenses$11,647,766PYTotalExpensesAmt
CY Total Expenses$10,816,215CYTotalExpensesAmt
PY Revenues Less Expenses-$421,101PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$537,561CYRevenuesLessExpensesAmt
Total Assets BOY$5,428,114TotalAssetsBOYAmt
Total Assets EOY$5,430,571TotalAssetsEOYAmt
Total Liabilities BOY$5,757,444TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,183,271TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$329,330NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,247,300NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,169,911ExpenseAmt
Revenue$11,320,127RevenueAmt
DescAvera 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 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 120 patient discharges, 12,619 outpatient visits, 293 swing-bed days, 9,583 clinic visits, and 10,099 nursing home resident days. Following is a breakdown of these statistics by facility:Avera Tyler Hospital120 Acute patient discharges12,619 Outpatient visits293 Swing-bed patient days6,664 Clinic visits - Tyler1,518 Clinic visits - Lake Benton1,401 Clinic visits - IvanhoeSunrise Manor10,099 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 $12,535.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 or 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$9,169,911TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee151EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Roger Pabst
Chair1.301.30Yes (X)Yes (X)$0$0$0
Joyce Strootman
Vice Chair1.301.30Yes (X)Yes (X)$0$0$0
Todd Bock
Director1.301.30Yes (X)$0$0$0
Quentin Fixen
Director1.301.30Yes (X)$0$0$0
Laurie Johansen
Director1.301.30Yes (X)$0$0$0
George Jorgesen
Director1.301.30Yes (X)$0$0$0
Doug Olsen
Director1.301.30Yes (X)$0$0$0
Sr Roxanne Seifert
Director1.301.30Yes (X)$0$0$0
Randy Serreyn
Director1.301.30Yes (X)$0$0$0
Sr Mary Joan Reichelt
Director1.301.30Yes (X)$0$0$0
Curtis Louwagie MD
Director/Ophthlalmologist1.3041.30Yes (X)$0$652,783$42,256
Sr Jodelle A Zimmerman
Director1.301.30Yes (X)$0$0$0
Mary Maertensex-officio wvote
President/CEO Avera Marsha2.5040.00Yes (X)Yes (X)$0$410,791$42,256
Jim Breckenridge
CFO Avera Health0.1039.90Yes (X)$0$887,406$34,116
Sharon Williams
VP Finance0.1040.00Yes (X)$0$188,237$34,022
Allen AndersonAdministrator
Former Officer40.000.00$0$109,637$16,806Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,248,854TotReportableCompRltdOrgAmt
Total Other Compensation$169,456TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Marshall
300 South Bruce StMarshallMN56258Physicians and Shared Services$2,275,535
Big Stone Therapies Inc
309 Washington AveOrtonvilleMN56278PT,OT, and Speech Therapy$607,920
Avera Health
3900 W Avera DrSioux FallsSD57108Shared Services$172,021
Avera McKennan
800 E 21st StSioux FallsSD57117Physicians, Lab, Radiology, and Other Cl$162,671
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$4,271RelatedOrganizationsAmt
Government Grants$14,400GovernmentGrantsAmt
Total Contributions$18,671TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue622110$11,136,794$11,136,794
Pharmacy Revenue900099$99,497$99,497

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,116TotalRevenueColumnAmt
Related Or Exempt Func Income$81,116RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,317,407TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,148TotalRevenueColumnAmt
Exclusion$8,148ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,830SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$6,830SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,830TotalRevenueColumnAmt
Exclusion$6,830ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescA/R Interest IncomeDesc
Business900099BusinessCd
Total Revenue Column$2,720TotalRevenueColumnAmt
Related Or Exempt Func Income$2,720RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,720OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,353,776TotalRevenueColumnAmt
Related Or Exempt Func Income$11,320,127RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$14,978ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,250,275TotalAmt
Program Services$3,013,227ProgramServicesAmt
Management And General$237,048ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$187,377TotalAmt
Program Services$182,631ProgramServicesAmt
Management And General$4,746ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$510,483TotalAmt
Program Services$489,992ProgramServicesAmt
Management And General$20,491ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$258,576TotalAmt
Program Services$250,324ProgramServicesAmt
Management And General$8,252ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$120TotalAmt
Management And General$120ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$36,793TotalAmt
Management And General$36,793ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$140TotalAmt
Management And General$140ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,377,582TotalAmt
Program Services$2,753,814ProgramServicesAmt
Management And General$623,768ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$645TotalAmt
Management And General$645ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$98,251TotalAmt
Program Services$74,732ProgramServicesAmt
Management And General$23,519ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$238,402TotalAmt
Program Services$238,402ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$57,190TotalAmt
Program Services$47,385ProgramServicesAmt
Management And General$9,805ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$710TotalAmt
Program Services$710ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,279TotalAmt
Program Services$4,279ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$767,325TotalAmt
Program Services$438,201ProgramServicesAmt
Management And General$329,124ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$82,203TotalAmt
Program Services$4,864ProgramServicesAmt
Management And General$77,339ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$974,089$974,089
Repairs and Maintenance$533,993$409,634$124,359
Bad Debt Expense$11,948$11,948
Licenses and Permits$911$911

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$424,923TotalAmt
Program Services$274,768ProgramServicesAmt
Management And General$150,155ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,816,215TotalAmt
Program Services$9,169,911ProgramServicesAmt
Management And General$1,646,304ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,020,464BOYAmt
EOY$1,754,713EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,073,605BOYAmt
EOY$913,374EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$239,725BOYAmt
EOY$217,612EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$152,383BOYAmt
EOY$69,337EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,682,893LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,884,359LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,453,014BOYAmt
EOY$1,798,534EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$483,419BOYAmt
EOY$673,634EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,200BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,304BOYAmt
EOY$3,367EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,428,114BOYAmt
EOY$5,430,571EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$736,016BOYAmt
EOY$588,365EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,967BOYAmt
EOY$5,818EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,933,838BOYAmt
EOY$190,168EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,073,623BOYAmt
EOY$398,920EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,757,444BOYAmt
EOY$1,183,271EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$703,710BOYAmt
EOY$3,819,319EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$166,612BOYAmt
EOY$220,213EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$207,768BOYAmt
EOY$207,768EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$329,330BOYAmt
EOY$4,247,300EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,428,114BOYAmt
EOY$5,430,571EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$537,561ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,917NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$4,041,986OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$140OtherActivitiesAmt
Total Lobbying Expenditures$140TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$157,440OtherCostOrOtherBasisAmt
Book Value$157,440BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,986,371OtherCostOrOtherBasisAmt
Depreciation$1,162,073DepreciationAmt
Book Value$824,298BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,557OtherCostOrOtherBasisAmt
Depreciation$3,344DepreciationAmt
Book Value$11,213BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,439,322OtherCostOrOtherBasisAmt
Depreciation$4,633,739DepreciationAmt
Book Value$805,583BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$85,203OtherCostOrOtherBasisAmt
Depreciation$85,203DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,798,534TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Pooled Investments$215,115F
Investment in Avera Health Foundation$458,519F
FieldValueIRS element (for citing)
Total Book Value Securities$673,634TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescThird Party Payor SettlementsDesc
Amt$398,920Amt
FieldValueIRS element (for citing)
Total Liability$398,920TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationAvera Health and most of its sponsored organizations are considered nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. These organizations are required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). Avera Health and certain sponsored organizations also file an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report their unrelated business taxable income. 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. The federal Form 990T filings and taxable subsidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2015. Certain consolidated entities are subject to federal income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. Deferred tax assets and liabilities are not material as of June 30, 2018 and 2017. The Organization paid an immaterial amount of federal and state income taxes for the years ended June 30, 2018 and 2017.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,211TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,211NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,728,462TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,356,202DirectOffsettingRevenueAmt
Net Community Benefit Expns$372,260NetCommunityBenefitExpnsAmt
Total Expense0.03450TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,734,673TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,356,202DirectOffsettingRevenueAmt
Net Community Benefit Expns$378,471NetCommunityBenefitExpnsAmt
Total Expense0.03510TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs2611ActivitiesOrProgramsCnt
Total Community Benefit Expns$6,740TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$330DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,410NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,270,229TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,542,697DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,727,532NetCommunityBenefitExpnsAmt
Total Expense0.15990TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs2611ActivitiesOrProgramsCnt
Total Community Benefit Expns$3,276,969TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,543,027DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,733,942NetCommunityBenefitExpnsAmt
Total Expense0.16050TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs2611ActivitiesOrProgramsCnt
Total Community Benefit Expns$5,011,642TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,899,229DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,112,413NetCommunityBenefitExpnsAmt
Total Expense0.19560TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$11,948BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$2,845,650ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,858,563CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$12,913MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera TylerBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 Willow StAddressLine1Txt
CityTylerCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56178ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.avera.org/tyler/WebsiteAddressTxt
State License371548StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other2 rural health clinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Avera TylerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Page 8OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part V, Page 8OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Page 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLsee Part VFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLsee Part VFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLsee Part VFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Avera TylerPart 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 acquired the consultant services of Andrea Fox Jensen to provide a more comprehensive look into the social determinants of health and wellness in the communities we serve.
Avera TylerPart V, Section B, Line 11: The three priorities and goals identified from the CHNA assessment were:1) Mental Health a) Goal: Provide access to a full spectrum of mental health services. Provide a collaborative care model involving primary care, mid-level mental health professionals, and qualified community agencies.2) Eldercare and Memory Care Servicesa) Goal: Provide access to a full spectrum of Elder Care Services with partnerships with clinics, health providers, public health, employers, schools, civic leaders, police/fire and regional elder care services providers.3) Coordination of Carea) Goal: Optimize access and coordination of care throughout continuum and to accomplish shared goals within and across care setting through enhanced access to care services with a consistent care team approach.Updates:1. Mental Healtha. Avera Tyler has developed a close relationship with Avera Marshall Behavior Health and has developed many best practices with their help. As a part of that work, Avera Tyler has developed in the areas of ensuring appropriate resources, dedicated and adequate physical space, and staff competencies as it relates to mental health. They also continue to meet and collaborate with local agencies to be able to continue to offer safe and consistent mental health care. 2. Elder Care Services a. Avera Tyler has implemented daily rounding where a provider rounds on residents on a daily basis. This has decreased the number of ER visits from nursing home residents and allows them to stay in their homes while providing daily access to a provider. eLTC capabilities were enhanced over the past year adding behavioral health services to its menu of options, further continuing to be responsive to our residents. Lastly, we have applied and were approved to start OnTrack, which is a nurse aid training program, which will allow us to train aids in a more timely fashion than the traditional route. This is in collaboration with Avera Marshall Morningside Heights and Divine Providence in Ivanhoe, MN. 3. Coordination of Carea. Avera Tyler has been active in the Accountable Care Organization and it has been going well for coordination of care. With this and other leveraged technologies on site (eLTC) and through our partnerships with other facilities and agencies, care coordination continues to be a main focus.
Avera TylerPart 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 TylerPart 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 TylerPart 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 TylerPart 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 7b:https://www.avera.org/about/community-health-needs-assessments/#tyler
Schedule H, Part V, Section B, Line 10a:https://www.avera.org/about/community-health-needs-assessments/#tyler
Schedule H, Part V, Section B, Lines 16a, 16b, and 16c:https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Avera Sunrise Manor
240 Willow StTylerMN56178Skilled nursing facility
3 - Avera Medical Group Ivanhoe
312 East George StreetIvanhoeMN56142Medical clinic

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted.
Part I, Line 7:Charity care on Line 7a was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part I, Ln 7 Col(f):Bad debt expense of $11,948 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage.
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 10 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Curtis Louwagie MD
Director/Ophthlalmologist$0$633,533$0$17,040$0$2,210$0$13,500$0$28,756$0$695,039$0$0
Mary Maertensex-officio wvote
President/CEO Avera Marsha$0$312,808$0$0$0$97,983$0$13,500$0$28,756$0$453,047$0$0
Jim Breckenridge
CFO Avera Health$0$815,781$0$0$0$71,625$0$13,500$0$20,616$0$921,522$0$0
Sharon Williams
VP Finance$0$169,936$0$0$0$18,301$0$9,158$0$24,864$0$222,259$0$0
Allen AndersonAdministrator
Former Officer$0$104,474$0$5,000$0$163$0$4,577$0$12,229$0$126,443$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3:FormAndLineReferenceDesc
ExplanationThe 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.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The 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 2Jim Breckenridge and Mary Maertens have a business relationship.
Form 990, Part VI, Section A, line 6The 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 7aAvera 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 7bAvera 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 11bThe 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 12cThe conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board.
Form 990, Part VI, Section B, line 15The CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.
Form 990, Part VI, Section C, line 19The organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public.
Form 990, Part IX, line 11gOther Fees: Program service expenses 2,753,814. Management and general expenses 173,768. Fundraising expenses 0. Total expenses 2,927,582. ACS Fees: Program service expenses 0. Management and general expenses 450,000. Fundraising expenses 0. Total expenses 450,000.
Form 990, Part XI, line 9:Transfer from related party 4,052,767. Intercompany transfer -11,320. Change in Interest in Avera Foundation 539.
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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 West Avera Drive Ste 300Sioux FallsSD57108460422673Promotion of HealthSD501(c)(3)Line 100
Avera St Anthony's Hospital
300 N 2nd StreetONeillNE68763470463911Healthcare servicesNE501(c)(3)Line 30Avera Health
Avera Holy Family
826 North 8th StreetEsthervilleIA51334420680370Healthcare servicesIA501(c)(3)Line 30Avera Health
Avera Holy Family Foundation
826 North 8th StreetEsthervilleIA51334421317452Support health related servicesIA501(c)(3)Line 100Avera Holy Family
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare servicesSD501(c)(3)Line 30Avera Health
St Benedict Health Center Foundation
West Glynn Drive PO Box BParkstonSD57366460458725Support health related servicesSD501(c)(3)Line 12a, I0St Benedict Health Center
Avera McKennan
1325 S Cliff Ave PO Box 5045Sioux FallsSD57117460224743Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera Queen of Peace Hospital
525 North FosterMitchellSD57301460224604Healthcare servicesSD501(c)(3)Line 30Avera Health
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera Gettysburg
606 East GarfieldGettysburgSD57442460234354Healthcare servicesSD501(c)(3)Line 30Avera St Mary's
Avera at Home
5116 S Solberg AveSioux FallsSD57108460399291Home servicesSD501(c)(3)Line 100Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare educationSD501(c)(3)Line 100Sacred Heart Health Services
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera Marshall
300 S Bruce StreetMarshallMN56258410919153Healthcare servicesMN501(c)(3)Line 30Avera Health
Avera Health Plans Inc
3900 West Avera Drive Suite 101Sioux FallsSD57108460451539Health financing and health plan adminSD501(c)(4)0Avera Health

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 Lincoln St NELemarsIA51031820582350Medical services - home medical equipmentSDN/A
Avera Home Medical Equipment of Sioux Center LLC
38 19th St SWSioux CenterIA51250753203100Medical services - home medical equipmentSDN/A
Q&M Properties LLC
525 North FosterMitchellSD57301731652049Medical clinic buildingSDN/A
Surgical Associates Endoscopy Clinic LLC
310 S PennAberdeenSD57401460461429Surgical associatesSDN/A
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota AveSioux FallsSD57117800619999Medical Services - home medical equipmentSDN/A
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare ServicesSDN/A
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101BrookingsSD57006453204123Healthcare ServicesSDN/A
National Rural ACO 4 LLC dba Prairie Hills Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153371780735Accountable Care OrganizationKSN/A
National Rural ACO 5 LLC dba Great Plains Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153383958290Accountable Care OrganizationKSN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Accounts Management Inc
5132 S Cliff Ave Suite 101Sioux FallsSD57108460373021Collection agencySDN/AC0
Avera Property Insurance Inc
610 W 23rd St PO Box 38YanktonSD57078460463155InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental Real EstateSDN/AC0
Alucent Medical Inc
1325 S Cliff Avenue PO Box 5045Sioux FallsSD571175045471818349Biotech ResearchSDN/AC0
South Dakota State Medical Holding Company Inc
2600 W 49th StreetSioux FallsSD57105460401087InsuranceSDN/AC0
DakotaCare Administrative Services Inc
2600 W 49th StreetSioux FallsSD57105460424322InsuranceSDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd