2012-05-14T14:20:15-05:00 2011-06-30 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2010-07-01 410919153 Avera Marshall AVER 5075329661 300 S Bruce Street Marshall MN 562581934 Paul Puetz 5075329661 2012-05-08 1 Kim Hunwardsen CPA 6122536500 2012-05-08 2010 2016-02-24 21:20:13Z Avera Marshall Regional Medical Cent Mary Maertens 300 S Bruce Street Marshall MN 562581934 56636566 0 X www.averamarshall.org X 1944 MN Promotion of health 13 10 535 168 172308 57647 342191 133845 47475117 54851086 257832 1397545 238413 71792 48313553 56454268 55410 61360 0 0 23814055 26616555 0 0 83164 23102003 24711457 46971468 51389372 1342085 5064896 61305296 70020471 24861049 26839447 36444247 43181024 X Avera is a health ministry rooted in the gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. 1 1 41659415 61360 54678778 Avera Marshall (dba Avera Marshall Regional Medical Center) is a non-profit organization, privately owned and operated by Avera Health. Avera Marshall consists of a 25-bed Critical Access Hospital, an attached 76-bed nursing home, three physician clinics, and five optometry clinics. The physician clinics include specialty services (ob/gyn, pediatrics, orthopedics, general surgery, and internal medicine), psychiatry services and ophthalmology services. In FY 2011, Avera Marshall had 4,216 patient days in addition to 951 newborn patient days, 409 swing-bed days, and 2,657 behavioral-health bed days.AWARDS AND RECOGNITIONAvera Marshall has been the recipient of five safety awards from the Minnesota Hospital Association over the past several years, including Safe from Falls June 2008, Safe Site October 2008, Safe Count January 2009, Safe Skin April 2009, Safe Account March 2011. STRATEGIC ACCOMPLISHMENTSJoint Ventures - A home medical equipment store in Marshall is a joint venture between Avera Marshall and Avera McKennan in Sioux Falls. The showroom features equipment and supplies ranging from small personal care items to beds and wheelchairs, in addition to oxygen supplies and service. Management agreements - Avera Marshall has a "Partner in Health Agreement" with other non-profit organizations, which include Divine Providence Health Center in Ivanhoe, MN, Western Mental Health Center in Marshall, MN and Prairie Home Hospice in Marshall, MN. Partnerships - Avera Marshall has a partnership arrangement for therapy services with Big Stone Therapies, Inc., to offer hospital and long term care based services to inpatients and outpatients. They have also worked with Prairie Home Hospice, a free-standing agency, upon request, to provide temporary management services and business analysis. Physician recruitment - Avera Marshall has been successful in recruiting 21 providers to the Avera Medical Group since 2009. Surgery Center - A new surgery center opened in the summer of 2010, featuring state-of-the art equipment and design concepts. It includes the same day surgery center and procedure/treatment rooms, along with four complete operating rooms.Community needs fulfillment - Avera Marshall is currently completing a community health needs assessment that will identify unmet needs in the community and be used for subsequent strategic planning purposes.Aging Services - The neighborhood model has resulted in changes to the way care is provided in the long term care facility. More choice from the resident on schedules, activities and dining experiences has resulted in some remodeling and modified staffing patterns. Transitions Care offers individuals a place for recovery and rehab following an illness, injury or surgery. Clinic addition - A physician office building is being constructed that will add 40 clinic rooms, lab and imaging space. The singular location for Avera Medical Group physicians to offer their services will enhance the patient experience and create a welcome, private environment for people needing physician services. Outreach - Avera Marshall has identified new outreach locations by the general surgeon, ob/gyn, orthopod and ophthalmologists increasing access in local communities by bringing the specialist to people and making it convenient for those who need care. This is especially important for the elderly populations who have concerns about travel or physical limitations. Palliative care services will be added to the community within the next year. 41659415 1 1 0 1 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 69 0 1 535 1 1 1 0 0 0 0 0 0 0 0 0 X 13 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 MN X Sharon Williams 5075379150 300 S Bruce St Marshall MN 562581934 X Dr Paul J Puetz 1.30 X X 0 0 0 James H Fuhrmann 1.30 X X 0 0 0 Robert J Byrnes 1.30 X 0 0 0 Roger Pabst 1.30 X 188937 0 8193 Arthur M Olson 1.30 X 0 0 0 Michael K Rich 1.30 X 0 0 0 Randy Gaffney 1.30 X 0 0 0 Sr Mary J Reichelt 1.30 X 0 0 0 Sr Joann Sturzl 1.30 X 0 0 0 Sr Jodelle A Zimmerman 1.30 X 0 0 0 Donna Hartfiel MD 40.00 X 0 306792 7095 Randy Serreyn 1.30 X 0 0 0 Jill Vroman MD 1.30 X 0 0 0 Mary B Maertens 40.00 X X 0 301191 26001 Sharon Williams 40.00 X 108031 0 23474 Richard Jueneman 40.00 X 257500 0 24325 Amber Boles 40.00 X 262413 0 9870 Jason Klein 40.00 X 246169 0 26563 Kevin Gildner MD 40.00 X 343458 0 17887 Curtis Louwagie MD 40.00 X 311286 0 18325 1717794 607983 161733 17 0 1 0 Avera McKennan 1001 E 21st ST Ste 401 Sioux Falls SD 57105 Physicians and Anciliary 3582363 Avera Health 3900 W Avera Dr Ste 301 Sioux Falls SD 57105 Central Service Fees 2295757 Big Stone Therapies 830 Roy ST Ortonville MN 56278 Therapy Services 1337074 Weatherby Locums PO Box 972633 Dallas TX 753972633 Locum Physicians 487119 Leonard Street & Deinard PA 150 South Fifth Ste 2300 Minneapolis MN 55402 Legal Services 474864 16 89626 44219 133845 Net Patient Service Re 622110 53791143 53791143 Miscellaneous Revenue 900099 474369 376066 98303 Cafeteria Revenue 900099 266931 218558 48373 Gain on Auxiliary 900099 230542 230542 Equity Earnings of Aff 900099 88101 62469 25632 54851086 671081 671081 216760 144968 71792 71792 71792 736793 27001 37330 736793 -10329 726464 726464 56454268 54678778 172308 1469337 61360 61360 357954 216991 140963 21050957 18204536 2782615 63806 962012 919342 42656 14 2948310 2527378 414542 6390 1297322 1110066 181611 5645 1059247 1059247 715084 715084 31140 31140 6053421 5126361 925060 2000 305887 305887 754965 689119 65038 808 483742 34542 449200 698568 697757 811 210945 132497 76714 1734 1149138 1149138 3843801 3363237 479324 1240 235740 92598 143142 Provision for income ta 21076 21076 Medical Supplies 6102571 6088917 13654 Fees, Taxes and Surchar 1294953 268309 1026644 Bad Debt Expense 518029 518029 Recruitment 490375 490375 742775 438162 303086 1527 51389372 41659415 9646793 83164 4498695 5512468 7267723 6594339 7778 230208 990380 1138457 483793 1276169 60902177 34383964 26450240 26518213 483225 1499855 19610155 25470583 972291 1240385 250500 264610 290516 275184 61305296 70020471 3962864 5984271 12388 6083 18300000 17992194 2585797 2856899 24861049 26839447 X 34944247 43181024 1500000 0 36444247 43181024 61305296 70020471 X 5064896 1671881 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 3237 0 0 0 3237 0 0 1 1500000 1500000 1500000 1500000 0 1 1 439812 439812 35428009 19731161 15696848 22464437 14024001 8440436 2569919 628802 1941117 26518213 Investment in Affiliated Organizations 235731 C Assets Limited to Use-Avera Pooled Investments 24614230 F Asset Backed Securities 620622 F 25470583 Capital Lease Obligation 737058 Estimated Third-Party Payor Settlements 1426260 Due to Affiliate 693581 2856899 Part IV, Line 2b: The Organization holds funds on behalf of its residents. Description of Intended Use of Endowment Funds: Part V, Line 4: All requirements of the endowment have been met. Therefore all funds were expended during the year. Description of Uncertain Tax Positions Under FIN 48: Part X: The Medical Center believes that it has appropraite 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 Medical Center 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 Medical Center's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2008. 1 1 X 1 X 1 X 1 1 1 0 1 1 313 278494 278494 0.00550 3108474 1587384 1521090 0.02990 313 3386968 1587384 1799584 0.03540 15 607 74498 1200 73298 0.00140 2 327 186451 7300 179151 0.00350 4 15342 7678164 4637736 3040428 0.05980 2 17100 2308 14792 0.00030 23 16276 7956213 4648544 3307669 0.06500 23 16589 11343181 6235928 5107253 0.10040 1 4170 4170 0.00010 1 8447 8447 0.00020 4 180 70290 70290 0.00140 1 152 152 0.00000 2 539 3123 3123 0.00010 9 719 86182 86182 0.00180 0 265005 13250 11034149 10897297 136852 X 1 1 1 1 Avera Marshall Regional Medical Center

300 S Bruce Street Marshall MN 56258

X X X X Not Required 1 10 Avera Morningside Heights Care Center

300 S Bruce Street Marshall MN 56258

nursing home, adult daycare Avera Marshall Specialty Clinic

300 S Bruce Street Marshall MN 56258

OB/GYN, general surgery, orthopedics, pediatrics, internal medicine Avera Marshall SW Ophthalmology

300 S Bruce Street Marshall MN 56258

ophthalmology, optical Avera Marshall Psychiatry Associates

1104 E College Drive Marshall MN 56258

psychiatry, psychology AM Group Optometry Redwood Falls

500 E Bridge Street Redwood Falls MN 56283

optometry, ophthalmology, optical Avera Marshall Group Optometry Windom

1006 4th Avenue Windom MN 56101

optometry, ophthalmology, optical AM Group Optometry Springfield

602 N Jackson Springfield MN 56087

optometry, ophthalmology, optical AM Group Optometry Mountain Lake

1040 3rd Avenue Mountain Lake MN 56169

optometry, ophthalmology Avera Marshall Group Optometry Tracy

505 State Street Tracy MN 56175

Optometry, ophthalmology, optical Curaquick Avera Marshall

900 E Main Street Marshall MN 56258

convenience clinic Part I, Line 3c: Patients with income less than 400% of the poverty guidelines are eligible for financial assistance. The organization has a grid that looks at income, assets and balance of current medical claims to determine eligibility based upon a sliding scale. It is possible to receive assistance from zero to 100%. Part I, Line 6a: Our 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 and unreimbursed Medicaid was converted to cost using the cost-to-charge ratio derived from Worksheet 2. Lines 7e - i are gathered from expenses reported in the general ledger. Part I, Line 7g: Subsidized health includes expenses related to a psychiatric and specialty clinics with community benefit expenses of $4,886,533. Part I, Line 7, Column (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 $ 518029. Part II: The amounts reported as community building include monetary and in-kind donations to community organizations to support the needs of the community beyond the need for healthcare. During this time, Avera Marshall donated a house to Habitat for Humanity. Avera Marshall's employees and management also volunteer and participate in area community organizations. These organizations include non-profit and civic organizations. Avera Marshall also encourages middle-school aged students to consider a career in healthcare through their Scrubs Camp which is a one-day program. These contributions strengthen the community by focusing on underlying causes of health care issues. Part III, Line 4: Bad debt expense was converted to cost using the cost-to-charge ratio derived from Worksheet 2.The estimated amount of bad debt expense attributable to patients eligible under the Organization's charity care policy is calculated by taking 5% of bad debt at cost. The Organization evaluates bad debt and identifies charity care as applicable. However, based on review of the bad debt the Organization estimates that 5% of bad debt at cost could be charity care as there are individuals who do not complete the paper work.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.Financial Statement Note:The carrying amount of patient receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients and third-party payors. Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. Management also reviews accounts to determine if classification as charity care is appropriate. Part III, Line 8: 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 CMS. 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 a reasonable time period, the Organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. At such time as the Organization sends the uncollected account to an outside collection agency, the amount referred to the agency shall reflect the reduced-payment level for which the patient was eligible under the Organization's financial assistance policy for low-income uninsured patients. Avera Marshall does not report any data to any of the credit agencies, however, the collection agencies Avera Marshall utilizes may report to the credit agencies. Any extended payment plans offered by the Hospital, or the Hospital's representative, in settling the outstanding bills of patients who qualify for financial assistance shall be interest-free so long as the repayment schedule is met. Part VI, Line 2: Avera Marshall, in conjunction with several other agencies located in the City of Marshall and the surrounding areas, is currently collaborating to put together a Community Health Needs Assessment. Several groups/organizations have been contacted and interviews set up in order to cultivate their needs and input. A target date of January 2012 has been set to quantify information received from these meetings. Part VI, Line 3: Anyone who is uninsured receives a letter with their itemized bill which describes both the uninsured program and the charity care program. Any uninsured patient is contacted by phone or letter by our collections department at which time our programs are described. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding our charity care and uninsured programs. Part VI, Line 4: Avera Marshall's service area includes Lyon County and surrounding counties in Minnesota. In 2010, the population for Lyon County was estimated to be 25,857. Approximately 13.6% of the population is age 65 or older. The average per capita income is $23,560 and approximately 11.7% of individuals are below the federal poverty level. The nearest hospital in the area is approximately 22 miles from Avera Marshall. Part VI, Line 6: 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. In addition, Avera Marshall is the sole provider for hospital inpatient care, the only physician staffed 24/7 ER, birthing center and full service surgery center. As a result of our mission statement, Avera Marshall provides numerous services which do not produce a profit. An example of this is psychiatric services provided by the facility. This is a subsidized health service. Avera Marshall also operates Curaquick to provide an alternative, low-cost convenience care for walk-in patients. Avera Marshall is very involved in the community. We offer classes such as childbirth and various other support groups. Planet Heart community screenings are provided with reduced imaging fees in addition to free vein screenings. We provide educational experiences for school-aged children, students needing work study experience and med student internships. Physicals for sports are given to students who have no means to pay but wish to participate in athletic activities at Marshall schools. Basic supply items are donated to school nurse providers for triage care. Avera Marshall participates in community health events such as Community Connect which provides options on accessing health care resources. The Foundation, a separate exempt organization, focused on raising dollars for community health needs, such as assistance with mammograms through the Tough Enough to Wear Pink campaign, the baby hat and blanket fund and more. They also offer many opportunities for community members to volunteer. Part VI, Line 7: 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 national importance. 1 Medical Student Scholarships 8 48000 Stipend for SIM (Student Internship in Medicine) Students 3 1500 LTC Employee Scholarships 20 11860 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The Organization provides scholarships to medical students, long-term care employees and a stipend to SIM (Student Internship in Medicine) students. The Organization monitors the use of the scholarships through a recruiter who maintains contact with the students, and monitors receipt of the employee scholarship by the learning institution. X X 0 0 0 0 0 0 0 0 0 Roger Pabst 168219 0 0 0 20718 0 600 0 7805 0 197342 0 0 0 Donna Hartfiel MD 0 299792 0 0 0 7000 0 0 0 7095 0 313887 0 0 Mary B Maertens 0 291769 0 0 0 9422 0 12102 0 15177 0 328470 0 0 Richard Jueneman 256067 0 0 0 1433 0 3500 0 21402 0 282402 0 0 0 Amber Boles 262184 0 0 0 229 0 3002 0 7445 0 272860 0 0 0 Jason Klein 245522 0 0 0 647 0 4738 0 22402 0 273309 0 0 0 Kevin Gildner MD 300808 0 0 0 42650 0 0 0 18332 0 361790 0 0 0 Curtis Louwagie MD 250549 0 0 0 60737 0 0 0 18856 0 330142 0 0 0 Supplemental Information Part III The President & CEO was compensated by Avera Health. Avera Marshall relied on the related organization for determining the compensation for the President & CEO using the methods described in Part I, Line 3. Dr Roger Pabst Community needs loan X 60000 33333 0 0 1 Dr Curtis Louwagie Community needs loan X 200000 100000 0 0 1 Dr Kevin Gildner Community needs loan X 150000 96875 0 0 1 230208 PBR Windom and Mountain Lake Board member was 20% owner in clinic 168209 Purchase of Optometry Clinics 0 New Program Services Form 990, Part III, line 2 12/2010 - Curaquick was added as a walk-in convenience care option for people in the area. It is located at 900 East Main Street in the Hy-Vee store in Marshall, MN. Changes in Program Services Form 990, Part III, line 3 The number of optometry clinics has increased for FYE 2011 by the addition of the following clinics: 03/01/2010 - Avera Medical Group Optometry Redwood Falls, located at 500 E. Bridge Street in Redwood Falls, MN 10/01/2010 - Avera Medical Group Optometry Springfield, located at 602 N. Jackson Avenue in Springfield, MN 07/01/2010 - Avera Medical Group Optometry Windom, located at 1006 Fourth Street in Windom, MN 07/01/2010 - Avera Medical Group Optometry Mountain Lake, located at 1040 Third Avenue in Mountain Lake, MN 01/01/2011 - Avera Medical Group Optometry Tracy, located at 505 State Street in Tracy, MN Form 990, Part VI, Section A, line 2 Donna Hartfiel, MD has a business relationship with Sr. Mary J. Reichelt. Form 990, Part VI, Section A, line 6 The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera Health, 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 Health has the following rights as the member. 1.To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of corporation; 2.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; 3.To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the member; 4.To approve any plan of merger, consolidation or dissolution of the corporation, or the divestiture of a sponsored work or ministry associated with the corporation; 5.To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the corporation; 6.To appoint and remove, with or without cause, the board of directors of the corporation; 7.To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the corporation; 8.To approve operating/capital budgets and strategic plans of the corporation; 9.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; 10.To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the members; 11.To establish and maintain employee benefit programs; 12.To establish and maintain insurance programs; 13.To approve major community fund drives; 14.To approve the appointment of auditors; 15.To adopt policies designed to effectuate the reserved powers of the member. Form 990, Part VI, Section B, line 11 The Form 990 is reviewed initially by the CEO and CFO, then the finance committee. The return is made available to the board of directors for review prior to filing. 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 President & CEO was 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 CFO is determined by Avera Marshall Human Resources based on a market analysis. The CEO approves the CFO's compensation. 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 VII: Michael Rich and Dr. Donna R. Hartfiel serve Avera Marshall Foundation, a related organization, .2 hours per week. Mary Maertens and Sharon Williams serve Avera Marshall Foundation, related organization, 1.2 and .1 hours per week, respectively. As board members, Sr. Mary J. Reichelt serves a related organization 2 hours per week and Sr. Joann Sturtzel serves a related organization 1 hour per week. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 1,671,881. Form 990, Part XII, Line 2c: The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the audited financial statements for Avera Marshall. Form 990, Part VI, Line 16b: There is no written policy or procedure in the event of any such proposed transaction. The board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. 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 N 8th Street Estherville IA 51334 420680370 Healthcare Services IA 501(c)(3) Line 3 Avera Health 0 Avera Holy Family Foundation 826 N 8th Street Estherville IA 51334 421317452 Support of Holy Family Hospital and Home Health Agency IA 501(c)(3) Line 9 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 460226738 Support Health Related Services SD 501(c)(3) Line 11a, 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 Sacred Heart Rural Health Clinics 501 Summit Street Yankton SD 57078 460423930 Clinic Services SD 501(c)(3) Line 3 Sacred Heart Health Services 0 Health Management Services 501 Summit Street Yankton SD 57078 460399291 Adult Daycare and Homemaking Services SD 501(c)(3) Line 9 Sacred Heart Health Services 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 9 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 Workers' Compensation Trust 3900 West Avera Drive Sioux Falls SD 57108 460407148 Economical Coverage of Workers' Compensation Claims SD 501(c)(3) Line 11b, II Avera Health 0 Avera Health 3900 West Avera Drive Suite 300 Sioux Falls SD 57108 460422673 Healthcare Services SD 501(c)(3) Line 9 N/A 0 Avera Marshall Foundation 300 S Bruce Street Marshall MN 56258 411784801 Fundraising MN 501(c)(3) Line 7 Avera Marshall 1 Avera Home Medical Equipment LLC 1425 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460488198 Medical Services - Home Medical Equipment SD N/A Midwest Regional Imaging Services LLC 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 470874983 Health Care - Medical Imaging SD N/A Mersco Medical of Pierre LLC 329 E Dakota Pierre SD 57501 460444002 Medical Services - Home Medical Equipment SD N/A 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 Estherville LLC PO Box 5045 Sioux Falls SD 57117 201686097 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 Avera Home Medical Equipment of Marshall LLC 1104 East College Drive Marshall MN 56258 205271924 Medical Services - Home Medical Equipment SD Avera Home Medical Equipment LLC Related 89434 286921 0 25632 0 0.50000 Q & M Properties 525 North Foster Mitchell SD 57301 731652049 Medical Clinic Building SD N/A Surgical Associates Endoscopy Clinic LLC 310 S Pennsylvania 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 10720 Sikes Place Suite 300 Charlotte NC 28277 562143771 Healthcare Services NC N/A Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection Agency SD N/A C Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health Financing and Health Plan Admin SD N/A C Avera Property Insurance Inc 610 W 23rd St PO Box 38 Yankton SD 57078 460463155 Insurance SD N/A C Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Medical Equipment SD N/A C 0 0 1 0 1 0 0 0 1 0 0 1 0 0 1 1 1 1 Avera Marshall Foundation