2025-05-14T14:19:49-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 420680370 Avera Holy Family AVER 7123626519 826 North 8th Street Estherville IA 51334 Julie Lautt CFO Avera Health 7123626519 2025-05-09 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-05-02 2023 2025-03-06 01:10:19Z Michelle Majerus 826 North 8th Street Estherville IA 51334 35903728 0 0928 X See Schedule O X 1996 IA Promotion of health 9 8 190 8 0 0 794244 25968 27411839 35123681 315215 722151 24406 31928 28545704 35903728 23758 11937 0 0 13494236 13207965 0 0 0 13129364 16634864 26647358 29854766 1898346 6048962 60276592 68362497 4099651 2203623 56176941 66158874 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. 0 0 26049617 11937 35131980 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, orthopedic and ophthalmology surgical services, nuclear medicine, wound care, emergency, ultrasound, 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 243 Acute inpatient discharges 98 Swing-bed patient discharges 28,328 Outpatient visits 757 Swing-bed patient days 15,064 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 $2,546,868.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. 26049617 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 41 0 1 190 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Deb Herzberg President/CEO 40.00 0.00 X X 0 207039 27859 Yas Mata Chair 1.00 0.00 X X 0 0 0 Mike Cornwall Vice Chair 1.00 0.00 X X 0 0 0 Trudy Ahrens Board Member (Beg 01/2024) 1.00 0.00 X 0 0 0 Sr Candyce Chrystal Board Member 1.00 7.00 X 0 0 0 Bob Jensen Board Member 1.00 0.00 X 0 0 0 Sr Janet Schumacher Board Member 1.00 0.00 X 0 0 0 Molly Struve Board Member (End 08/2023) 1.00 0.00 X 0 0 0 Jim Rosendahl Board Member 1.00 0.00 X 0 0 0 Penny Clayton Board Member 1.00 0.00 X 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1203675 19401 Linda Adams Nurse Manager 40.00 0.00 X 116117 0 19128 Martin Bergstrom Chief Nursing Officer 40.00 0.00 X 109249 0 39254 Nancy Diekmann Nurse Manager 40.00 0.00 X 118840 0 24127 April Sue Krull Pharmacist 40.00 0.00 X 128334 0 45411 Kristi Hough Manager - Pharmacy 40.00 0.00 X 164291 0 48843 636831 1410714 224023 8 0 1 0 Avera Health 3900 W Avera Drive Sioux Falls SD 57108 Shared Services 2618641 Docs Emergency Medicine Inc 800 W Frontier Lane Olathe KS 66061 Medical/Locum Services 1709033 Avera McKennan 1325 S Cliff Ave Sioux Falls SD 57117 Medical Services 805583 Psychiatric Medical Care LLC 4322 Harding Pike 417 Nashville TN 37205 Medical Services 405850 Woodward Anesthesia Services PC 203 N 8th St Estherville IA 51334 Medical Professional Services 285873 9 5258 13210 7500 25968 Patient Service Revenue 621110 31776706 31776706 Pharmacy Revenue 456110 3227654 3227654 Patient and Clinic 621110 25503 25503 93818 93818 35123681 14784 14784 23629 0 23629 23629 23629 707167 200 0 0 707167 200 707367 707367 AR Interest Income 900099 8299 8299 8299 35903728 35131980 0 745780 X 11937 11937 10345327 10054918 290409 424920 410842 14078 1709160 1658843 50317 728558 710357 18201 1800 1800 2198 2198 7908443 5689099 2219344 4871 115 4756 279012 232562 46450 127197 126207 990 469285 429046 40239 37136 34705 2431 34536 31011 3525 1456299 1313190 143109 102609 18564 84045 Medical Supplies 5014823 5000755 14068 Equipment Lease/Rental 74804 27720 47084 Bad Debt 5048 5048 1116803 294698 822105 29854766 26049617 3805149 0 459758 -38351 3091147 3590555 567626 606429 109441 85220 36375516 23880254 12763584 12495262 43149255 50538253 114911 152336 20870 932793 60276592 68362497 1662984 1368946 9660 0 2427007 834677 4099651 2203623 X 55285391 65080193 891550 1078681 56176941 66158874 60276592 68362497 X 6048962 3472775 460196 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2198 2198 0 Part II-B, Line 1: Avera Holy Family paid dues to organizations which have a portion of the dues attributed to lobbying activities. 2362025 52271 249102 10605 2652793 2161342 21024 198406 18747 2362025 2219508 207261 -252374 13053 2161342 1859198 369234 8925 2219507 1807087 69640 -7644 9884 1859199 0.86492 0.11622 0.01887 0 1 1 510540 510540 23412546 14644752 8767794 11496333 8747016 2749317 956097 488486 467611 12495262 Avera Pooled Investments 46587271 F Investment in Foundation 3950982 F 50538253 Estimated Third-Party Settlements 834677 834677 X 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. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 1084956 1084956 0.03630 2832594 2341144 491450 0.01650 3917550 2341144 1576406 0.05280 23755 23755 0.00080 72453 72453 0.00240 7994793 3206934 4787859 0.16040 83080 12500 70580 0.00240 8174081 3219434 4954647 0.16600 12091631 5560578 6531053 0.21880 123 123 0.00000 419 419 0.00000 2638 2638 0.00010 9 9 0.00000 3189 3189 0.00010 1 0 9513085 9534458 -21373 X 1 1 1 1 Avera Holy Family Health 826 N 8th Street Estherville IA 51334 See Part V Section C 320014H X X X X Provider Based Clinic Avera Holy Family 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V Section C X See Part V Section C X 1 21 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V Section C X See Part V Section C X See Part V Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Avera Holy Family Part V, Section B, Line 5: Avera Holy Family Hospital initiated community discussion groups and the community health needs 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. All of those providing community input represent the interests of medically underserved populations and provided helpful information related to the needs of the community. The following organizations were represented in the process: * Emmet County Public Health* Avera Holy Family Medical Staff* Emmet County Wellness Coalition* Nursing Home Leaders* Fire, Law Enforcement, Ambulance and Support Services (FLEAS) Avera Holy Family Part V, Section B, Line 11: The priority areas to be addressed by Avera Holy Family include: 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 in FY2024 to address the identified and prioritized community health needs:COVID-19 MITIGATIONInfection Control (IC) nurse updates informational posters that are in place in the hospital for patient education. IC nurse, lab manager, and pharmacy manager continually send out new information to leaders and Medical Staff when new recommendations from the CDC are available and when new vaccines are available at Avera Holy Family. Medical staff is updated by pharmacy of new variants and treatments monthly either at Professional Activities or Medical Staff Meetings. Electronic sign installed along the highway with a message running 24/7 that encourages the public to get their COVID vaccination. ACCESS TO MENTAL HEALTH CARE*Promote awareness of mental health issues Senior Life Solutions continued to work with organizations 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 concerns Avera Holy Family is working 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 uses 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 SERVICES*Collaborate with medical staff to identify options for expanding services to allow more flexible and convenient hours of service to the community Avera Holy Family continues to recruit for physicians to join the practice. We have also expanded our Therapy department to accommodate more patients and get them in for needed therapy whether it is PT/OT/ST. Avera Holy Family has switched from Precision Diagnostic Services to Avera Sleep Lab for home and in house sleep studies. This transition has increased the access to these services in a timely manner. Low immunization rates- The AMG-Estherville medical group has been working to get permission for the Vaccines for Children program so that patients are able to get their needed vaccinations in our clinic versus having to make additional appointments at outside facilities which will hopefully lead to more timely and compliant vaccine programs. Lack of access to dental care- Emmet County has been able to get more openings in the free dental clinic. AMG Estherville medical group received a grant to provide fluoride varnish and toothbrushes to children to help with dental health.CARDIOVASCULAR DISEASE/HYPERTENSION*Raise awareness of the factors that contribute to heart disease and measures to prevent disease Expanded dates to provide for quicker appointments for Planet Heart screenings. Started the Better Choices Better Health classes. Continued with Diabetic Education classes including virtual classes.*Ensure people at risk have access to diagnosis and appropriate treatment*Promote healthy eating and physical activity Continued Diabetic Education as well as starting a Better Choices Better Health class to promote healthy eating. Pharmacists have also started working with patients individually with physician oversight to help get better control of their health especially diabetes.*Encourage smoking cessationEARLY DETECTION OF CANCER*Promote awareness of contributing factors and signs and symptoms of cancer Focused on Breast Cancer Awareness month at the hospital and continue to get people scheduled for their yearly mammograms. Working with the hospital foundation to make funds available for breast cancer screening for individuals that cannot afford it.*Encourage screening for early detectionOBESITY*Raise awareness of the impact obesity has on quality of life, incidence of disease and medical complications, and healthcare costs*Collaborate with Emmet County Public Health, Emmet County Wellness Coalition, and other community partners to promote physical activity and wellness*Raise 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 habitsMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.Needs identified and not being addressed and why include:Lack of parenting skills- Better addressed by another community partnerAlcohol and drug abuse- Lack of professional resources, competing priorities and projects 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/ 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 FY2023 cost report. Subsidized health services were calculated based on a combination of the FY2023 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. During the year ended June 30, 2024, the Organization adjusted the qualifying criteria under the charity care policy, which resulted in a reclassification of accounts considered bad debt in previous years that now qualified as presumptive charity care under the adjusted policy. Implicit price concession for the year of $558,221 was reduced for prior year reclassifications of $1,722,901 resulting in a net negative implicit price concession of $1,164,680. Due to the negative implicit price concession per the general ledger, an amount of $0 has been reported on Line 2. 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 19 and 20. 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 FY2023 Medicare cost report. The FY2023 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 2023 data, the estimated population of Emmet County as of July 1, 2023 is 6,229 and is predominately white at 93.9%. It is estimated that 24.1% of the population is 65 years and over. The median household income is $64,461 with an 11.5% poverty rate. Uninsured individuals under age 65 is estimated at 7.9%. 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. 1 Regional Transit Authority ART PO Box 1240 Spencer IA 51301 421133312 501(c)(3) 7500 0 Support Estherville community transportation 1 0 Part I, Line 2: 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. 1 0 0 0 0 0 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0 1197590 0 480 0 5605 0 16500 0 2901 0 1223076 0 0 Deb Herzberg President/CEO 0 203649 0 0 0 3390 0 10458 0 17401 0 234898 0 0 Kristi Hough Manager - Pharmacy 157694 0 440 0 6157 0 8746 0 40098 0 213135 0 0 0 April Sue Krull Pharmacist 127617 0 255 0 462 0 6873 0 38538 0 173745 0 0 0 Part I, Line 4a Linda Adams received a severance payment of $57,013. Nancy Diekmann received a severance payment of $62,246. Schedule J, Part I, Line 3: The President/CEO's compensation is paid by a related organization, Avera McKennan. 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. 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 and Deb Herzberg have a business relationship. 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 President/CEO is compensated by Avera McKennan, a related exempt organization. Avera McKennan has a process in place for determining compensation. The CFO-Avera Health is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. 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 2,286,949. Management and general expenses 72,951. Fundraising expenses 0. Total expenses 2,359,900. Medical Professional Fees: Program service expenses 2,330,887. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,330,887. Repairs & Maintenance: Program service expenses 595,172. Management and general expenses 15,742. Fundraising expenses 0. Total expenses 610,914. Centralized Services: Program service expenses 476,091. Management and general expenses 2,130,651. Fundraising expenses 0. Total expenses 2,606,742. Form 990, Part XI, line 9: Change in Interest in Avera Foundation 273,065. Change in Assets with Donor Restrictions 187,131. 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. 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 Avera Health 0 Avera at Home 5300 S Broadband Lane Sioux Falls SD 57108 460399291 Home Services SD 501(c)(3) Line 10 Avera Health 0 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) Avera Health 0 Avera Marshall 300 S Bruce St Marshall MN 56258 410919153 Healthcare Services MN 501(c)(3) Line 3 Avera Health 0 Avera Granite Falls 345 10th Ave Granite Falls MN 56241 843156881 Healthcare Services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare Services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Queen of Peace Hospital 525 North Foster Street Mitchell SD 57301 460224604 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare Services NE 501(c)(3) Line 3 Avera Health 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare Services SD 501(c)(3) Line 3 Avera St Mary's 0 Holy Family Hospital Foundation 826 N 8th Street Estherville IA 51334 421317452 Support Health Related Services IA 501(c)(3) Line 10 Avera Holy Family 1 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 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 Avera Health 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 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 300 22nd Ave Brookings SD 57006 453204123 Medical services - home medical equipment SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 611843657 Accountable Care Organization TX N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 4055 Valley View Lane Ste 700 Dallas TX 75244 821447782 Accountable Care Organization TX N/A 0 0 Heart Hospital of South Dakota LLC 4500 W 69th St Sioux Falls SD 57108 562143771 Healthcare Services SD N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Penn St Aberdeen SD 57401 460461429 Surgical associates SD N/A 0 0 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 Level 10 30 Collings Street Melbourne VIC 3000 AS Biotech research AS N/A 0 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 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0