AVERA HOLY FAMILY: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization: AVERA HOLY FAMILY (EIN 42-0680370)
Tax period: 2024-07-01 to 2025-06-30
Filed: 2026-05-15
IRS object ID: 202641359349304104
Schema version: 2024v5.5
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2026-05-15T09:25:54-05:00	ReturnTs
Tax Period End	2025-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Eide Bailly LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	800 Nicollet Mall Ste 1300	AddressLine1Txt
City	Minneapolis	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554027033	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2024-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	420680370	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Holy Family	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AVER	BusinessNameControlTxt
Phone	7123626519	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	826 North 8th Street	AddressLine1Txt
City	Estherville	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51334	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Julie Lautt	PersonNm
Person Title	CFO Avera Health	PersonTitleTxt
Phone	7123626519	PhoneNum
Signature	2026-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2026-05-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2024	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Michelle Majerus	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	826 North 8th Street	AddressLine1Txt
City	Estherville	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51334	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$38,249,103	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	See Schedule O	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1996	FormationYr
Legal Domicile State	IA	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	8	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	189	TotalEmployeeCnt
Total Volunteers	20	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$25,968	PYContributionsGrantsAmt
CY Contributions Grants	$16,617	CYContributionsGrantsAmt
PY Program Service Revenue	$35,123,681	PYProgramServiceRevenueAmt
CY Program Service Revenue	$35,840,669	CYProgramServiceRevenueAmt
PY Investment Income	$722,151	PYInvestmentIncomeAmt
CY Investment Income	$2,343,040	CYInvestmentIncomeAmt
PY Other Revenue	$31,928	PYOtherRevenueAmt
CY Other Revenue	$48,777	CYOtherRevenueAmt
PY Total Revenue	$35,903,728	PYTotalRevenueAmt
CY Total Revenue	$38,249,103	CYTotalRevenueAmt
PY Grants And Similar Paid	$11,937	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$9,936	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$13,207,965	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,683,298	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$521	CYTotalFundraisingExpenseAmt
PY Other Expenses	$16,634,864	PYOtherExpensesAmt
CY Other Expenses	$17,493,867	CYOtherExpensesAmt
PY Total Expenses	$29,854,766	PYTotalExpensesAmt
CY Total Expenses	$31,187,101	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,048,962	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,062,002	CYRevenuesLessExpensesAmt
Total Assets BOY	$68,362,497	TotalAssetsBOYAmt
Total Assets EOY	$79,193,311	TotalAssetsEOYAmt
Total Liabilities BOY	$2,203,623	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,760,834	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$66,158,874	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$76,432,477	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$26,865,782	ExpenseAmt
Grant	$9,936	GrantAmt
Revenue	$35,867,385	RevenueAmt
Desc	Avera Holy Family's mission is to provide healthcare services to Estherville, Iowa residents and residents of the surrounding area. Avera Holy Family is a 501(c)(3) organization affiliated with Avera Health. Avera Holy Family consists of a 25-bed critical access hospital and a clinic in Estherville, Iowa. The program services offered include primary care, general surgery, ENT, orthopedic and ophthalmology surgical services, wound care, pain management, emergency, imaging services, laboratory, behavioral health, speech therapy, physical therapy, and occupational therapy. Avera Holy Family provides acute healthcare services. Following is a breakdown of these statistics by facility:Avera Holy Family Hospital 275 Acute inpatient discharges 94 Swing-bed patient discharges 29,393 Outpatient visits 790 Swing-bed patient days 14,734 Clinic visitsAvera Holy Family 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 $395,176.Avera Holy Family 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 Holy Family upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera Holy Family engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed.	Desc
Total Program Service Expenses	$26,865,782	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	48	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	189	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	8	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Jamie Schaefer	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053223992	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3900 W Avera Dr Ste 300	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57108	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Julie Lautt
CFO Avera Health;Secretary/Treasurer	0.10	46.30	Yes (X)	$0	$1,274,363	$20,218
Kristi Hough
Manager - Pharmacy	40.00	0.00		$174,609	$0	$50,293	Yes (X)
Deb Herzberg
President/CEO (Until Oct.)	42.00	0.00	Yes (X)	$0	$166,757	$24,082		Yes (X)
April Sue Krull
Pharmacist	40.00	0.00		$134,622	$0	$46,201	Yes (X)
Martin Bergstrom
Chief Nursing Officer	40.00	0.00		$115,870	$0	$41,043	Yes (X)
Gemaima Marie Mumar Flor
Medical Laboratory Scient	40.00	0.00		$109,292	$0	$21,060	Yes (X)
Kari Ann Sorenson
Director - Clinical Services	40.00	0.00		$107,744	$0	$47,848	Yes (X)
Michelle Majerus
President/CEO (Beg. Oct.)	41.00	0.00	Yes (X)	$22,840	$32,924	$3,515		Yes (X)
Yas Mata
Chair	1.00	0.00	Yes (X)	$0	$0	$0		Yes (X)
Mike Cornwall
Vice Chair	1.00	0.00	Yes (X)	$0	$0	$0		Yes (X)
Trudy Ahrens
Board Member	1.00	0.00		$0	$0	$0		Yes (X)
Sr Candyce Chrystal
Board Member	1.00	7.00		$0	$0	$0		Yes (X)
Cody Newgard
Board Member	1.00	0.00		$0	$0	$0		Yes (X)
Jim Rosendahl
Board Member	1.00	0.00		$0	$0	$0		Yes (X)
Penny Clayton
Board Member	1.00	0.00		$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$664,977	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,474,044	TotReportableCompRltdOrgAmt
Total Other Compensation	$254,260	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	9	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Avera Health
3900 W Avera Drive	Sioux Falls	SD	57108	Shared Services	$2,861,898
Docs Who Care Inc
800 W Frontier Lane	Olathe	KS	66061	Medical and Locum Services	$1,804,042
Journey Group Companies
4500 W 58th St	Sioux Falls	SD	57108	Construction	$535,544
Psychiatric Medical Care LLC
8 Cadillac Dr Ste 230	Brentwood	TN	37027	Medical Services	$484,263
Woodward Anesthesia Services PC
203 N 8th St	Estherville	IA	51334	Medical Professional Services	$297,726

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	7	CntrctRcvdGreaterThan100KCnt
Related Organizations	$12,678	RelatedOrganizationsAmt
Government Grants	$3,939	GovernmentGrantsAmt
Total Contributions	$16,617	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue	621110	$32,395,228	$32,395,228
Pharmacy Revenue	456110	$3,278,884	$3,278,884
Patient and Clinic	621110	$57,979	$57,979

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$108,578	TotalRevenueColumnAmt
Related Or Exempt Func Income	$108,578	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$35,840,669	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$477	TotalRevenueColumnAmt
Exclusion	$477	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$22,061	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$22,061	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,061	TotalRevenueColumnAmt
Exclusion	$22,061	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,341,263	SecuritiesAmt
Other	$1,300	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,341,263	SecuritiesAmt
Other	$1,300	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,342,563	TotalRevenueColumnAmt
Exclusion	$2,342,563	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	AR Interest Income	Desc
Business	900099	BusinessCd
Total Revenue Column	$26,716	TotalRevenueColumnAmt
Related Or Exempt Func Income	$26,716	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$26,716	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$38,249,103	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,867,385	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$2,365,101	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$9,936	TotalAmt
Program Services	$9,936	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$139,407	TotalAmt
Management And General	$139,407	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,599,870	TotalAmt
Program Services	$10,429,471	ProgramServicesAmt
Management And General	$170,399	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$439,776	TotalAmt
Program Services	$432,432	ProgramServicesAmt
Management And General	$7,344	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,745,160	TotalAmt
Program Services	$1,704,837	ProgramServicesAmt
Management And General	$40,323	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$759,085	TotalAmt
Program Services	$736,476	ProgramServicesAmt
Management And General	$22,609	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,765	TotalAmt
Program Services	$3,765	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$2,200	TotalAmt
Management And General	$2,200	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,043	TotalAmt
Management And General	$2,043	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,739,112	TotalAmt
Program Services	$6,061,636	ProgramServicesAmt
Management And General	$2,677,476	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$5,636	TotalAmt
Management And General	$5,636	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$274,927	TotalAmt
Program Services	$220,732	ProgramServicesAmt
Management And General	$54,195	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$148,556	TotalAmt
Program Services	$147,766	ProgramServicesAmt
Management And General	$790	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$509,762	TotalAmt
Program Services	$425,982	ProgramServicesAmt
Management And General	$83,780	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$40,436	TotalAmt
Program Services	$36,032	ProgramServicesAmt
Management And General	$4,404	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$37,178	TotalAmt
Program Services	$33,426	ProgramServicesAmt
Management And General	$3,752	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,531,481	TotalAmt
Program Services	$1,450,909	ProgramServicesAmt
Management And General	$80,572	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$48,736	TotalAmt
Management And General	$48,736	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$4,877,160	$4,861,314	$15,846
Equipment Lease/Rental	$35,979	$18,716	$17,263

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,236,896	TotalAmt
Program Services	$292,352	ProgramServicesAmt
Management And General	$944,023	ManagementAndGeneralAmt
Fundraising	$521	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$31,187,101	TotalAmt
Program Services	$26,865,782	ProgramServicesAmt
Management And General	$4,320,798	ManagementAndGeneralAmt
Fundraising	$521	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	-$38,351	BOYAmt
EOY	$123,725	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,590,555	BOYAmt
EOY	$3,123,024	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$606,429	BOYAmt
EOY	$617,934	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$85,220	BOYAmt
EOY	$123,454	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$37,769,882	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$25,370,079	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$12,495,262	BOYAmt
EOY	$12,399,803	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$50,538,253	BOYAmt
EOY	$58,191,582	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$152,336	BOYAmt
EOY	$120,229	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$932,793	BOYAmt
EOY	$4,493,560	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$68,362,497	BOYAmt
EOY	$79,193,311	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,368,946	BOYAmt
EOY	$1,903,851	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$834,677	BOYAmt
EOY	$856,983	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,203,623	BOYAmt
EOY	$2,760,834	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$65,080,193	BOYAmt
EOY	$75,204,799	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,078,681	BOYAmt
EOY	$1,227,678	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$66,158,874	BOYAmt
EOY	$76,432,477	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$68,362,497	BOYAmt
EOY	$79,193,311	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,062,002	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$2,723,757	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$487,844	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$2,043	OtherActivitiesAmt
Total Lobbying Expenditures	$2,043	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	Avera Holy Family paid dues to organizations which have a portion of the dues attributed to lobbying activities.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,652,793	BeginningYearBalanceAmt
Contributions	$52,015	ContributionsAmt
Investment Earnings Or Losses	$287,255	InvestmentEarningsOrLossesAmt
Other Expenditures	$11,743	OtherExpendituresAmt
End Year Balance	$2,980,320	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,362,025	BeginningYearBalanceAmt
Contributions	$52,271	ContributionsAmt
Investment Earnings Or Losses	$249,102	InvestmentEarningsOrLossesAmt
Other Expenditures	$10,605	OtherExpendituresAmt
End Year Balance	$2,652,793	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,161,342	BeginningYearBalanceAmt
Contributions	$21,024	ContributionsAmt
Investment Earnings Or Losses	$198,406	InvestmentEarningsOrLossesAmt
Other Expenditures	$18,747	OtherExpendituresAmt
End Year Balance	$2,362,025	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,219,508	BeginningYearBalanceAmt
Contributions	$207,261	ContributionsAmt
Investment Earnings Or Losses	-$252,374	InvestmentEarningsOrLossesAmt
Other Expenditures	$13,053	OtherExpendituresAmt
End Year Balance	$2,161,342	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,859,198	BeginningYearBalanceAmt
Investment Earnings Or Losses	$369,234	InvestmentEarningsOrLossesAmt
Other Expenditures	$8,925	OtherExpendituresAmt
End Year Balance	$2,219,507	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.84897	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.13763	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.01340	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$510,540	OtherCostOrOtherBasisAmt
Book Value	$510,540	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,539,427	OtherCostOrOtherBasisAmt
Depreciation	$15,450,749	DepreciationAmt
Book Value	$8,088,678	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,507,545	OtherCostOrOtherBasisAmt
Depreciation	$9,207,364	DepreciationAmt
Book Value	$3,300,181	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,212,370	OtherCostOrOtherBasisAmt
Depreciation	$711,966	DepreciationAmt
Book Value	$500,404	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$12,399,803	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Avera Pooled Investments	$53,752,755	F
Investment in Foundation	$4,438,827	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$58,191,582	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	Intercompany Assets	Desc
Book Value	$4,493,560	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$4,493,560	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Estimated Third-Party Settlements	$819,566
Intercompany Liabilities	$37,417

Field	Value	IRS element (for citing)
Total Liability	$856,983	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part V, Line 4:

The Organization's endowments consist of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions.

Part X, Line 2:

Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$160,947	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$160,947	NetCommunityBenefitExpnsAmt
Total Expense	0.00520	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,721,271	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,255,728	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$465,543	NetCommunityBenefitExpnsAmt
Total Expense	0.01490	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,882,218	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,255,728	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$626,490	NetCommunityBenefitExpnsAmt
Total Expense	0.02010	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,367	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,544	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$61,823	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$46,220	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$46,220	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,382,736	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,482,930	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,899,806	NetCommunityBenefitExpnsAmt
Total Expense	0.15710	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$79,032	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,125	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,907	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,574,355	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,530,599	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,043,756	NetCommunityBenefitExpnsAmt
Total Expense	0.16180	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,456,573	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,786,327	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,670,246	NetCommunityBenefitExpnsAmt
Total Expense	0.18190	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,228	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$13,228	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,103	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,103	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,331	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,331	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,011,770	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$9,377,084	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,407,295	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$30,211	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Holy Family Health	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	826 N 8th Street	AddressLine1Txt
City	Estherville	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51334	ZIPCd

Field	Value	IRS element (for citing)
Website Address	See Part V Section C	WebsiteAddressTxt
State License	320014H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	Provider Based Clinic	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Holy Family	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	24	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Part V Section C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	See Part V Section C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	24	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V Section C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	250.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Part V Section C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Part V Section C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Part V Section C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Avera Holy Family	Part V, Section B, Line 5: Collaboration between Avera Holy Family, Emmet County Iowa Public Health and various community partners resulted in the CHNA. A survey was conducted November 18, 2024 to December 30, 2024. The survey was provided to community members via a variety of methods. 140 individuals completed the survey. Community input was gathered through community partners and service groups that represented the broad interests of the community. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources, and improvements. Those providing community input represent the interests of medically underserved populations and provided helpful information related to the needs of the community.
Avera Holy Family	Part V, Section B, Line 6b: Emmet County Iowa Public Health
Avera Holy Family	Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Limited or no access to mental health care - Education and wellness related to aging - Drug/alcohol addictionPRIORITY 1: Limited or No Access to Mental Health Care - Develop a community guide listing available service providers - Identify barriers to services, including but not limited to transportation, cost, and communication options with respect to HIPAA - Navigate the statewide realignment of services - Identify and mitigate gaps in service created by statewide realignment - Promote mental health awareness to reduce stigmaPRIORITY 2: Education and Wellness Related to Aging - Promote aging services - Promote active aging to reduce stigmaPRIORITY 3: Drug and Alcohol Addiction - Encourage genetic screening and early intervention, routine mental health screenings, therapeutic intervention, and integrated treatment - Promote support services - Facilitate action to reduce access to drugs and alcohol, neighborhood improvement, school-based preventions programs, after-school programs, parental involvement, safe housing and employment, and anti-stigma campaigns.Other health related needs and services identified but will not be addressed, include:- Transportation barriers- Affordable Housing- Resources for life skills- Healthy cooking/cooking on a budgetAvera Holy Family does not currently have the resources to directly address all the identified needs. However, the leadership team recognizes that the needs exist and will continue to actively participate in numerous community organizations focused on community needs and improvement.Avera Holy Family continued to address the community health needs identified in the community health needs assessment completed in FY2022. Avera Holy Family maintained its implementation plan for each of the priorities of Covid Mitigation, Access to mental health care, Access to urgent/convenient healthcare, Cardiovascular disease/hypertension, Early detection of cancer, and Obesity. The following actions were taken during FY2025 to address the needs identified in the FY2022 community health needs assessment:COVID-19 MITIGATIONAvera Holy Family continued to follow CDC recommendations pertaining to vaccines and patient monitoring and testing. Appropriate employee health measures were implemented based on exposure and symptom management as well as length of days of work.ACCESS TO MENTAL HEALTH CAREPromote awareness of mental health issuesAvera Holy Family continued to work with Senior Life Solutions to promote mental health in elderly people. Senior Life Solutions also worked with promoting suicide awareness in the community and among hospital employees.Identify resources to address mental health concernsAvera Holy Family continued to work with Flowstate and the Sioux Rivers Regional Mental Health agency to provide needed support for patients with mental health issues. Flowstate works to help with assessment and placement of the patients and Sioux Rivers works with the patient post discharge to try and keep them from needing placement again in the future. Avera Holy Family also continued to use Avel eBehavioral Health to work with the patients who have been admitted to inpatient or observation care and will do reassessments and start medications on patients before they are sent for inpatient treatment. ACCESS TO URGENT/CONVENIENT HEALTH CARE SERVICESCollaborate with medical staff to identify options for expanding services to allow more flexible and convenient hours of service to the communityAvera Sleep Lab has made more appointments available and currently has no wait list to obtain an in-house or at-home sleep study. Avera Holy Family Therapy department has hired 2 new PT's and is now able to see all patients within a timely manner.Avera Medical Group-Estherville has been approved to give vaccines through the Vaccines for Children program making childhood vaccinations more readily available.CARDIOVASCULAR DISEASE/HYPERTENSIONRaise awareness of the factors that contribute to heart disease and measures to prevent diseaseEnsure people at risk have access to diagnosis and appropriate treatmentPromote healthy eating and physical activity Encourage smoking cessationAvera Holy Family continues to address cardiovascular disease and hypertension through Planet Heart screenings. Employees have also reached out to provide education to the community regarding the signs of heart attack and stroke and the importance of seeking prompt treatment. Avera Holy Family has continued to expand the practice of pharmacists seeing more patients in clinic as well as doing discharge teaching of medications for patients who are being discharged.EARLY DETECTION OF CANCERPromote awareness of contributing factors and signs and symptoms of cancerEncourage screening for early detectionAvera Holy Family continues to provide education to the public concerning cancer risks and screening options by means of social media, community outreach like the educational booths mentioned above and encouragement to continue yearly screening. Avera Holy Family has increased their reach to include text messaging to encourage patients to schedule their annual mammogram screenings. The clinic continues to offer low dose CT for lung cancer screening for eligible patients.Avera Holy Family worked with the hospital foundation to make funds available for breast cancer screening for individuals that cannot afford it. We had our first breast cancer screening for an individual that could not afford it and have gotten the process simplified and ready for future patients. Patients who are uninsured or underinsured can receive financial assistance with mammography and annual Pap screening costs through the Care for Yourself program.OBESITYRaise awareness of the impact obesity has on quality of life, incidence of disease and medical complications, and healthcare costsCollaborate with Emmet County Public Health, Emmet County Wellness Coalition, and other community partners to promote physical activity and wellnessRaise awareness on the impact that poor eating habits have on health and wellness*Collaborate with Emmet County Public Health, Emmet County Wellness Coalition, and other community partners to promote healthier eating habitsAvera Holy Family provides education to the community through the Better Choices Better Health Program which helps adults and their caregivers manage symptoms of chronic diseases such as heart disease, diabetes, depression, asthma, bronchitis, emphysema, and others. Avera Holy Family also supports community programs including the bike safely event and the Emmet County Wellness Coalition. Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.
Avera Holy Family	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 Holy Family	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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Holy Family	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 Holy Family	Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Schedule H, Part V, Section B, Line 7a, 7b and 10a:	avera.org/about/community-health-needs-assessments/
Schedule H, Part V, Section A organization's website:	avera.org/locations/profile/avera-holy-family-hospital/
Schedule H, Part V, Section B, Lines 16a, 16b, and 16c:	avera.org/patients-visitors/charity-patient-assistance-programs/

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/.
Part I, Line 7:	Charity care was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost report. Subsidized health services were calculated based on a combination of the Medicare cost report and an overall cost-to-charge ratio for certain expenses. Community health improvement services, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded to the general ledger.
Part II, Community Building Activities:	The organization supports and donates to various community organizations focusing on issues impacting the community's health and safety.
Part III, Line 2:	The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents.
Part III, Line 4:	The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 18 and 19.
Part III, Line 8:	Avera Holy Family provides services to patients under the Medicare program knowing they may 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, in years the costs associated with services provided under the Medicare program are not completely covered, 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:	The hospital utilizes the Press Ganey patient Experience Survey to gather information about patients' perceptions of their care experiences. The survey helps us know how to improve care and services to better meet the needs of our community.The Professional Activities Committee of the Medical Staff meets eight times a year to discuss patient needs, evaluate care and services, and identify opportunities to enhance care and services. The Medical Staff meets quarterly to discuss these same topics. The other duty of both parties is to ensure all providers who are considered for the Medical Staff have the proper credentials and training that are needed before voting to accept them as part of the organizations Medical Staff.The Critical Access CAH Committee meets quarterly to provide bi-annual policy review of all patient care policies. The CAH committee also approves new patient care and service policies and procedures while also evaluating care and services of patients. After the CAH committee approves these policies and procedures, they are then sent to the Hospital Board for final approval.
Part VI, Line 3:	Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same-day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs.
Part VI, Line 4:	Avera Holy Family is a 25-bed critical access hospital in Estherville, Iowa. The primary service area is defined as Emmet County, Iowa, including the communities of Armstrong, Dolliver, Estherville, Gruver, Ringsted, and Wallingford. Estherville is the county seat. According to the U.S. Census Bureau Quick Facts 2025 data, the estimated population of Emmet County as of July 1, 2024 is 9,162 and is predominately white at 93.6%. It is estimated that 24.6% of the population is 65 years and over. The median household income is $63,730 with an 11.9% poverty rate. Uninsured individuals under age 65 is estimated at 8.1%.
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 and are given final approval by the governing body. Surplus funds are reinvested in facilities to improve patient care. The Organization supports the free clinic in the community; conducts public health screenings; participates in community health fairs; provides health education to community and schools; donates to various community organizations and health care scholarships; provides tours for school children; utilizes telecare; provides preceptorships for students; and provides Meals on Wheels.
Part VI, Line 6:	Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Regional Transit Authority ART	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 1240	AddressLine1Txt
City	Spencer	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51301	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	421133312	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$7,500	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Purpose Of Grant	Support Estherville community transportation	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The organization provides grants/contributions to other organizations which are tax-exempt under IRC Section 501(c)(3) and governmental divisions that benefit the community and region through programs and activities.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Julie Lautt
CFO Avera Health;Secretary/Treasurer	$0	$1,226,098	$0	$41,964	$0	$6,301	$0	$17,250	$0	$2,968	$0	$1,294,581	$0	$0
Kristi Hough
Manager - Pharmacy	$168,166	$0	$460	$0	$5,983	$0	$9,283	$0	$41,010	$0	$224,902	$0	$0	$0
Deb Herzberg
President/CEO (Until Oct.)	$0	$163,662	$0	$0	$0	$3,095	$0	$8,460	$0	$15,622	$0	$190,839	$0	$0
April Sue Krull
Pharmacist	$134,140	$0	$270	$0	$212	$0	$7,202	$0	$38,999	$0	$180,823	$0	$0	$0
Martin Bergstrom
Chief Nursing Officer	$115,664	$0	$0	$0	$206	$0	$6,201	$0	$34,842	$0	$156,913	$0	$0	$0
Kari Ann Sorenson
Director - Clinical Services	$106,950	$0	$675	$0	$119	$0	$6,006	$0	$41,842	$0	$155,592	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 3:	FormAndLineReferenceDesc
Explanation	The President/CEO's compensation was paid by a related organization, Avera McKennan, until October 2024 at which time there was a change in leadership. Avera Holy Family relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Item J:	The organization's website is: avera.org/locations/profile/avera-holy-family-hospital/
Form 990, Part VI, Section A, line 2	Julie Lautt has a business relationship with Michelle Majerus and Deb Herzberg. Julie Lautt and Sr. Candyce Chrystal have a business relationship.
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, as the sole member, has the following rights as the Member: 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of the 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, SD ("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 CEO of the Corporation; 8) To approve the 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 Member; 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 A, line 8b	There is no committee with authority to act on behalf of the Board.
Form 990, Part VI, Section B, line 11b	The Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members.
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 compensation amount and structure for the Avera Holy Family's CEO is derived from Avera Health's comparative data in cooperation with a compensation consultant who utilized multiple salary survey results with predominant factors of FTE, revenue, and operating expenses to benchmark the CEO position to similar healthcare organization data. The compensation for the CEO is then approved by Avera McKennan President and CEO. The CFO of Avera Health is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of the Caring for Life Catholic Health Ministries Members of Avera Health, meet 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 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	Purchased Services: Program service expenses 2,148,883. Management and general expenses 51,439. Fundraising expenses 0. Total expenses 2,200,322. Medical Professional Fees: Program service expenses 2,696,068. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,696,068. Repairs & Maintenance: Program service expenses 700,443. Management and general expenses 27,216. Fundraising expenses 0. Total expenses 727,659. Centralized Services: Program service expenses 516,242. Management and general expenses 2,598,821. Fundraising expenses 0. Total expenses 3,115,063.
Form 990, Part XI, line 9:	Change in Interest in Avera Foundation 338,847. Change in Assets with Donor Restrictions 148,997.
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 Holy Family.
Form 990, Part X, Line 20:	Avera Holy Family 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 Granite Falls, Avera Gettysburg, and Avera at Home. Avera Holy Family was not allocated any share of the bond issue, and thus does not have an amount on line 20 related to the Obligated group bond issuance.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 W Avera Drive Suite 300	Sioux Falls	SD	57108	460422673	Promotion of Health	SD	501(c)(3)	Line 10	N/A	0
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera at Home
5300 S Broadband Lane	Sioux Falls	SD	57108	460399291	Home Services	SD	501(c)(3)	Line 10		0	Avera Health
Avera Health Plans Inc
3900 W Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health Financing and Health Plan Admin	SD	501(c)(4)			0	Avera Health
Avera Marshall
300 S Bruce St	Marshall	MN	56258	410919153	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Health
Avera Granite Falls
345 10th Ave	Granite Falls	MN	56241	843156881	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Marshall
Avera Tyler
240 Willow Street	Tyler	MN	56178	410853163	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Marshall
Avera Queen of Peace Hospital
525 North Foster Street	Mitchell	SD	57301	460224604	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare Services	NE	501(c)(3)	Line 3		0	Avera Health
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera St Mary's
Holy Family Hospital Foundation
826 N 8th Street	Estherville	IA	51334	421317452	Support Health Related Services	IA	501(c)(3)	Line 10		Yes (1)	Avera Holy Family
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9	Yankton	SD	57078	460337013	Healthcare Services	SD	501(c)(3)	Line 10		0	Avera Health
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
5300 S Broadband Lane	Sioux Falls	SD	57108	820582350	Medical services - home medical equipment	SD	N/A	0	0
Avera Home Medical Equipment of Lakes Regional Healthcare LLC
5300 S Broadband Lane	Sioux Falls	SD	57108	862949748	Medical services - home medical equipment	SD	N/A	0	0
Avera Home Medical Equipment of Sioux Center LLC
5300 S Broadband Lane	Sioux Falls	SD	57108	753203100	Medical services - home medical equipment	SD	N/A	0	0
Avera Home Medical Equipment of Spencer Hospital LLC
5300 S Broadband Lane	Sioux Falls	SD	57108	800619999	Medical services - home medical equipment	SD	N/A	0	0
Brookings Health System - Avera HME LLC
100 22nd Ave Suite 101	Brookings	SD	57006	453204123	Medical services - home medical equipment	SD	N/A	0	0
Caravan Health ACO 15 LLC dba Prairie Vista Care Organization
20 Burton Hills Blvd Ste 100	Nashville	TN	37215	611843657	Accountable Care Organization	MO	N/A	0	0
Caravan Health ACO 41 LLC dba Prairie View Care Organization
20 Burton Hills Blvd Ste 100	Nashville	TN	37215	821447782	Accountable Care Organization	MO	N/A	0	0
Heart Hospital of South Dakota LLC
4500 W 69th St	Sioux Falls	SD	57108	562143771	Healthcare Services	NC	N/A	0	0
Surgical Associates Endoscopy Clinic LLC
310 S Penn St	Aberdeen	SD	57401	460461429	Surgical associates	SD	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Accounts Management Inc
5132 S Cliff Avenue Suite 101	Sioux Falls	SD	57108	460373021	Collection Agency	SD	N/A	C	0
Alucent Australia Pty Ltd
					Biotech research		N/A		0	Level 10 30 Collings Street	Melbourne	VIC 3000	AS	AS
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	Biotech research	SD	N/A	C	0
Avera Property Insurance Inc
1000 West 4th Street Suite 1	Yankton	SD	57078	460463155	Insurance	SD	N/A	C	0
DakotaCare Administrative Services Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460424322	Insurance	SD	N/A	C	0
Kore Cares In Home Services LLC
5300 South Broadband Lane	Sioux Falls	SD	57108	882778902	In-home care services	SD	N/A	S	0
South Dakota State Medical Holding Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460401087	Insurance	SD	N/A	C	0
Valley Health Services
501 Summit Street	Yankton	SD	57078	460357149	Rental real estate	SD	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Schedule R, Part II, Tax Exempt Organizations:	Holy Family Hospital Foundation dissolved November 2024.
Form 990, Schedule R, Part IV, Corporation or Trust:	Valley Health Services dissolved June 2025. Alucent Biomedical, Inc. dissolved May 2025. Alucent Australia Pty Ltd dissolved May 2025.