2019-05-14T15:28:19-05:00 2018-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-07-01 410853163 Avera Tyler AVER 5072475521 240 Willow Street Tyler MN 56178 Jim Breckenridge CFO Avera Health 5072475521 2019-05-10 1 Kim Hunwardsen CPA P00484560 6122536500 2019-05-10 8.39.233.107 2019-05-10 14:38:15 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 2017 2019-02-21 02:37:17Z Mary Maertens 240 Willow Street Tyler MN 56178 11353776 0 X www.avera.org X 1918 MN Promotion of health 13 11 151 40 0 0 176278 18671 10759073 11317407 38636 14978 252678 2720 11226665 11353776 1000 0 0 0 5152126 4206711 0 0 0 6494640 6609504 11647766 10816215 -421101 537561 5428114 5430571 5757444 1183271 -329330 4247300 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 9169911 11320127 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 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. 9169911 1 0 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 25 0 1 151 1 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 Roger Pabst Chair 1.30 1.30 X X 0 0 0 Joyce Strootman 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 Jorgesen Director 1.30 1.30 X 0 0 0 Doug Olsen Director 1.30 1.30 X 0 0 0 Sr Roxanne Seifert Director 1.30 1.30 X 0 0 0 Randy Serreyn Director 1.30 1.30 X 0 0 0 Sr Mary Joan Reichelt Director 1.30 1.30 X 0 0 0 Curtis Louwagie MD Director/Ophthlalmologist 1.30 41.30 X 0 652783 42256 Sr Jodelle A Zimmerman Director 1.30 1.30 X 0 0 0 Mary Maertensex-officio wvote President/CEO Avera Marsha 2.50 40.00 X X 0 410791 42256 Jim Breckenridge CFO Avera Health 0.10 39.90 X 0 887406 34116 Sharon Williams VP Finance 0.10 40.00 X 0 188237 34022 Allen AndersonAdministrator Former Officer 40.00 0.00 X 0 109637 16806 0 2248854 169456 0 1 1 0 Avera Marshall 300 South Bruce St Marshall MN 56258 Physicians and Shared Services 2275535 Big Stone Therapies Inc 309 Washington Ave Ortonville MN 56278 PT,OT, and Speech Therapy 607920 Avera Health 3900 W Avera Dr Sioux Falls SD 57108 Shared Services 172021 Avera McKennan 800 E 21st St Sioux Falls SD 57117 Physicians, Lab, Radiology, and Other Cl 162671 4 4271 14400 18671 Patient Service Revenue 622110 11136794 11136794 Pharmacy Revenue 900099 99497 99497 81116 81116 11317407 8148 8148 6830 0 6830 6830 6830 A/R Interest Income 900099 2720 2720 2720 11353776 11320127 0 14978 X 3250275 3013227 237048 187377 182631 4746 510483 489992 20491 258576 250324 8252 120 120 36793 36793 140 140 3377582 2753814 623768 645 645 98251 74732 23519 238402 238402 57190 47385 9805 710 710 4279 4279 767325 438201 329124 82203 4864 77339 Medical Supplies 974089 974089 Repairs and Maintenance 533993 409634 124359 Bad Debt Expense 11948 11948 Licenses and Permits 911 911 424923 274768 150155 10816215 9169911 1646304 0 1020464 1754713 1073605 913374 239725 217612 152383 69337 7682893 5884359 2453014 1798534 483419 673634 2200 3304 3367 5428114 5430571 736016 588365 13967 5818 1933838 190168 3073623 398920 5757444 1183271 X -703710 3819319 166612 220213 207768 207768 -329330 4247300 5428114 5430571 X 537561 -2917 4041986 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 140 140 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 1162073 824298 14557 3344 11213 5439322 4633739 805583 85203 85203 0 1798534 Pooled Investments 215115 F Investment in Avera Health Foundation 458519 F 673634 Third Party Payor Settlements 398920 398920 X Part X, Line 2: Avera 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. 1 1 X 1 X 1 X 1 1 0 0 6211 6211 0.00060 1728462 1356202 372260 0.03450 1734673 1356202 378471 0.03510 2611 6740 330 6410 0.00060 3270229 1542697 1727532 0.15990 2611 3276969 1543027 1733942 0.16050 2611 5011642 2899229 2112413 0.19560 1 11948 0 2845650 2858563 -12913 X 1 1 1 1 Avera Tyler 240 Willow St Tyler MN 56178 www.avera.org/tyler/ 371548 X X X X 2 rural health clinics Avera Tyler 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X See Part V, Page 8 X See Part V, Page 8 X 1 15 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 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 Tyler Part 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 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 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/ 2 1 - Avera Sunrise Manor 240 Willow St Tyler MN 56178 Skilled nursing facility 3 - Avera Medical Group Ivanhoe 312 East George Street Ivanhoe MN 56142 Medical clinic 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. 0 0 0 0 0 0 0 0 0 Curtis Louwagie MD Director/Ophthlalmologist 0 633533 0 17040 0 2210 0 13500 0 28756 0 695039 0 0 Mary Maertensex-officio wvote President/CEO Avera Marsha 0 312808 0 0 0 97983 0 13500 0 28756 0 453047 0 0 Jim Breckenridge CFO Avera Health 0 815781 0 0 0 71625 0 13500 0 20616 0 921522 0 0 Sharon Williams VP Finance 0 169936 0 0 0 18301 0 9158 0 24864 0 222259 0 0 Allen AndersonAdministrator Former Officer 0 104474 0 5000 0 163 0 4577 0 12229 0 126443 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 2,753,814. 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. 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