2018-05-11T10:55:57-05:00 2017-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-07-01 410853163 Avera Tyler AVER 5072475521 240 Willow Street Tyler MN 56178 Allen Anderson Administrator 5072475521 2018-05-08 1 Kim Hunwardsen CPA P00484560 6122536500 2018-05-08 2016 2022-09-23 18:48:47Z Allen Anderson 240 Willow Street Tyler MN 56178 11235858 0 X www.avera.org X 1918 MN Promotion of health 15 13 180 41 0 0 223790 176278 4077818 10759073 595 38636 561 252678 4302764 11226665 0 1000 0 0 1952011 5152126 0 0 0 2454567 6494640 4406578 11647766 -103814 -421101 5109581 5428114 4915088 5757444 194493 -329330 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. 1 1 9712915 1000 10761691 Avera Tyler is a 21 bed hospital, a 38 bed skilled nursing facility, and has rural healthcare clinics located in Tyler and Lake Benton, Minnesota. Inpatient, outpatient, clinic, and long term care services are provided to the residents of Lincoln County, Pipestone County, and Lyon County in southwest Minnesota. The membership of the corporation of Avera Tyler is controlled by Avera Marshall. This transfer of membership took place on March 1, 2016. Prior to this time, the Tyler Healthcare Center Inc. was an independent healthcare facility. The membership of the Avera Marshall corporation is controlled by Avera Health whose headquarters are located in Sioux Falls South Dakota. Avera Tyler is governed by the Avera Tyler Board of Directors. For the fiscal year ending June 30, 2017 there were 7,933 clinic visits, 9,651 long term care resident days and 600 hospital inpatient days. The transition to the Avera system has begun to strengthen the financial status of the organization. The change in ownership has also renewed the community's interest in the organization. Avera Tyler will continue to strive to meet the needs of the community and the region.Avera Tyler renewed its Trauma 4 designation in July 2016.Avera Sunrise Manor added access to Avera eLong Term Care (telemedicine) to provide residents access to providers 24/7 without leaving the long term care facility.The operating room was remodeled during the fiscal year in anticipation of increased volumes due to increasing specialty physicians seeing patients in Tyler on a routine basis. 9712915 1 0 0 0 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 32 0 1 180 1 0 0 0 0 0 0 0 0 0 0 X 15 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X Sharon Williams 5075379150 300 South Bruce Street Marshall MN 56258 Roger Pabst Chair/Physician 1.30 15.30 X X 0 6633 1390 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 James Fuhrmann Director 1.30 1.30 X 0 0 0 Randy Gaffney 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 642364 30230 Sr Jodelle A Zimmerman Director 1.30 1.30 X 0 0 0 Mary Maertensex-officio wvote President/CEO Avera Marshall 2.50 40.00 X X 0 396527 30230 Sharon Williams VP Finance 0.10 40.00 X 0 186445 27192 Allen Anderson Administrator 40.00 0.00 X 0 0 0 0 1231969 89042 0 0 1 0 Avera Marshall 300 South Bruce St Marshall MN 56258 Physicians and Shared Services 1848603 Avera Health 3900 W Avera Dr Sioux Falls SD 57108 Shared Services 459657 Big Stone Therapies Inc 309 Washington Ave Ortonville MN 56278 PT,OT, and Speech Therapy 392696 Avera McKennan 800 E 21st St Sioux Falls SD 57117 Physicians, Lab, Radiology, and Other Cl 114987 4 21622 154656 176278 Patient Service Revenue 622110 10638602 10638602 Pharmacy Revenue 900099 67431 67431 Change in Foundation 900099 -373 -373 53413 53413 10759073 47829 47829 9193 -9193 -9193 -9193 Insurance Recovery 900099 250060 250060 A/R Interest Income 900099 2618 2618 252678 11226665 10761691 0 288696 X 1000 1000 3906069 3531003 375066 250692 227981 22711 707988 659854 48134 287377 265728 21649 2315 2315 52042 52042 3051385 2441639 609746 188 188 91127 59550 31577 16 16 219635 219635 59391 55005 4386 7410 7410 785052 448943 336109 82906 3986 78920 Medical Supplies 983433 983433 Repairs and Maintenance 607261 400009 207252 Bad Debt Expense 121004 121004 431475 286719 144756 11647766 9712915 1934851 0 556737 1020464 687531 1073605 258272 239725 131670 152383 7575977 5122963 2924537 2453014 392877 483419 156868 2200 1089 3304 5109581 5428114 798256 736016 107642 13967 1937018 1933838 2072172 3073623 4915088 5757444 X -125076 -703710 111801 166612 207768 207768 194493 -329330 5109581 5428114 X -421101 2466 -105188 X X 0 1 X 1 0 X 157440 157440 1937800 1018780 919020 5341060 4007434 1333626 139677 96749 42928 2453014 Pooled Investments 76793 F Investment in Avera Health Foundation 406626 F 483419 Third Party Payor Settlements 346015 Due to Avera Marshall 2727608 3073623 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 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 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 subisidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2014. 1 1 X 1 X 1 X 1 1 0 1 1 67115 67115 0.00580 1788261 1450906 337355 0.02930 1855376 1450906 404470 0.03510 2912531 1380024 1532507 0.13300 2912531 1380024 1532507 0.13300 4767907 2830930 1936977 0.16810 1 121004 0 3128491 3144630 -16139 X 1 1 1 1 Avera Tyler 240 Willow St Tyler MN 56178 www.avera.org/tyler/ 371548 X X X X Rural health clinics in Tyler and Lake Benton 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 http://www.avera.org/experience/ah/financial-assistance-charity-care/ X http://www.avera.org/experience/ah/financial-assistance-charity-care/ X http://www.avera.org/experience/ah/financial-assistance-charity-care/ X X X X X X X 1 X 0 X X X X X 1 X 0 1 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.Here are the 6/30/17 updates:1. Mental Healtha. Avera Tyler has worked towards a closer relationship with Avera Marshall Behavioral Health as a place to go for best practices in regards to the mental health process for the facility. On top of that, Avera Tyler has hosted and facilitated meetings and communications with all Lincoln EMS providers and law enforcement to ensure all units were on the same page and offering consistency in care in mental illness cases. Those meetings are ongoing. 2. Elder Care Servicesa. Avera Tyler has been diligent in its elder care services by advancing capabilities in this discipline to ensure all caregivers have enhanced training and are working to their capacity. In order to continue the advancement of elder care services, Avera Tyler implemented a telehealth program, called eLong-Term Care, through the Avera eservices. This has enhanced our resident experience through the use of technology and was implemented to provide appropriate care in the comfort of our resident's home, and not through the emergency room when at all possible. Another change to the long-term care services offered, Avera Tyler will be de-licensing eight (8) beds, bringing their capacity to 30 beds. This will allow for the creation of more private rooms for resident satisfaction purposes. Lastly, a process we are meeting to operationalize is daily rounding with a list of providers to provide daily cares for residents that are in need. 3. Coordination of Carea. As of January 1, 2018, Avera Tyler will join an Accountable Care Organization, which offers the resources of coordinated care to the providers. This is to ensure a team-based care delivery program. The expectation is the program will provide for a more highly functional team. 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: Individuals eligible for financial assistance are not charged gross charges for emergency or other medically necessary care; however may be charged gross charges for elective care. 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, Line 7a: https://www.avera.org/app/files/public/65510/2016-chna-tyler.pdf 5 1 - Avera Sunrise Manor 240 Willow St Tyler MN 56178 Skilled nursing facility 2 - Tyler Home Care 240 Willow St Tyler MN 56178 Skilled home care services (closed 3/1/17) 3 - Avera Medical Group Tyler 240 Willow St Tyler MN 56178 Medical clinic 4 - Avera Medical Group Lake Benton 109 East Benton St Lake Benton MN 56149 Medical clinic 5 - Ridgeview Hospice 240 Willow St Tyler MN 56178 Hospice care (closed 3/1/17) Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 6a: The Avera Tyler community benefit report is contained in a report prepared by Avera Health, a related organization. It is available through the website and requested mailing, and is filed with the Catholic Health Association. 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): The bad debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $121,004. 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 is reported at charges as recorded by the organization. Part III, Line 3: Avera Tyler does not believe that any portion of bad debt expense could reasonably be attributed to patients who may qualify for financial assistance since evaluations are completed to determine those amounts due and will be reclassified from bad debt expense to charity care within 30 days of the evaluation of the amount. 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: The communities in which Avera operates all have unique health and community benefit needs and in keeping with the Catholic Healthcare Association guidelines each hospital strives to meet its community's identified needs. The Avera central office advocates for all on community benefit related matters of state, regional and nation importance. 0 0 0 0 0 0 0 0 0 Curtis Louwagie MD Director/Ophthlalmologist 0 640404 0 0 0 1960 0 5300 0 27000 0 674664 0 0 Mary Maertensex-officio wvote President/CEO Avera Marshall 0 391247 0 0 0 5280 0 5300 0 25736 0 427563 0 0 Sharon Williams VP Finance 0 185622 0 0 0 823 0 3510 0 25188 0 215143 0 0 Schedule J, Part I, Line 3: The President & CEO serves both Avera Marshall and Avera Tyler and was compensated by 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 III, line 2 Avera Tyler began offering sports medicine services to Russell - Tyler - Ruthton Schools. This includes an athletic trainer at many sporting events. Added Candice Vanderplaats, CNP, to the AMG Tyler team in April 2017 to expand access to endocrinology care currently provided by Dr. Ocampo. Dr. Ocampo expanded endocrinology services through outreach to Granite Falls, Minnesota. Avera Marshall began providing specialty services in Tyler in the specialties of OB/GYN, pediatrics, orthopedics and general surgery. Form 990, Part III, line 3 Discontinued Saturday morning urgent care hours in May 2017 due to low utilization. On March 1, 2017 the Tyler Home Care and Ridgeview Hospice activities were merged with the like services being performed in Marshall. The name was changed to d/b/a Avera@Home Southwest Minnesota and is operated by Avera Marshall, a related entity. 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 Mary Maertens has a business relationship with Sr. Mary J. Reichelt. Form 990, Part VI, Section A, line 6 The Member of this Corporation shall be Avera Marshall, a nonprofit corporation organized and existing under the laws of the State of Minnesota. Form 990, Part VI, Section A, line 7a Avera Marshall is the sole member, for Avera Tyler. Avera Health is the sole member of Avera Marshall and 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 initially by the CEO and CFO of Avera Marshall and the Administrator of Avera Tyler. The 990 is then reviewed by the Finance Committee. The return is provided to the Board of Directors for review prior to filing via the Board portal. 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 is 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. The compensation of the VP of Finance is determined by Human Resources based on a market analysis of comparable positions. The compensation is approved by the CEO. 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 2,441,639. Management and general expenses 159,746. Fundraising expenses 0. Total expenses 2,601,385. 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 3,356. Intercompany transfer -108,544. 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. 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 of Holy Family Hospital and Home Health Agency 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 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