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AVERA MARSHALL: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
AVERA MARSHALL (EIN 41-0919153)
Tax period
2023-07-01 to 2024-06-30
Filed
2025-05-14
IRS object ID
202521349349308692
Schema version
2023v6.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-14T14:20:26-05:00ReturnTs
Tax Period End2024-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410919153EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera MarshallBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone5075329661PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP562581934ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJulie LauttPersonNm
Person TitleCFO Avera HealthPersonTitleTxt
Phone5075329661PhoneNum
Signature2025-05-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2025-05-02PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Avera Marshall Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDebbie StreierPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP562581934ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$151,424,422GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.avera.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1944FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPromotion of healthActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee860TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$18,968TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$10,584NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$766,756PYContributionsGrantsAmt
CY Contributions Grants$407,857CYContributionsGrantsAmt
PY Program Service Revenue$137,508,574PYProgramServiceRevenueAmt
CY Program Service Revenue$150,368,471CYProgramServiceRevenueAmt
PY Investment Income$166,465PYInvestmentIncomeAmt
CY Investment Income$469,295CYInvestmentIncomeAmt
PY Other Revenue$114,305PYOtherRevenueAmt
CY Other Revenue$169,180CYOtherRevenueAmt
PY Total Revenue$138,556,100PYTotalRevenueAmt
CY Total Revenue$151,414,803CYTotalRevenueAmt
PY Grants And Similar Paid$7,371PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$35,813CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$64,889,641PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$70,266,125CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$638CYTotalFundraisingExpenseAmt
PY Other Expenses$69,954,268PYOtherExpensesAmt
CY Other Expenses$76,726,263CYOtherExpensesAmt
PY Total Expenses$134,851,280PYTotalExpensesAmt
CY Total Expenses$147,028,201CYTotalExpensesAmt
PY Revenues Less Expenses$3,704,820PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,386,602CYRevenuesLessExpensesAmt
Total Assets BOY$91,701,135TotalAssetsBOYAmt
Total Assets EOY$101,603,031TotalAssetsEOYAmt
Total Liabilities BOY$24,375,960TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,220,083TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$67,325,175NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$73,382,948NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$135,083,961ExpenseAmt
Grant$35,813GrantAmt
Revenue$150,424,898RevenueAmt
DescAvera Marshall's mission is to provide healthcare services to Marshall, Minnesota residents and residents of the surrounding area. Avera Marshall is a 501(c)(3) organization affiliated with Avera Health. Avera Marshall consists of a 25-bed critical access hospital plus 10 behavioral health beds and a 76-bed nursing home in Marshall, Minnesota, eight physician clinics and seven optometry clinics. The program services offered include primary care, general surgery, neurology (via telemed), dermatology, pediatrics, orthopedics, OB/GYN, urology, oncology, podiatry, psychiatry, nephrology, radiology, optometry, ophthalmology, level III trauma center, ICU, speech therapy, physical therapy, and occupational therapy. Avera Marshall provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera Marshall Hospital 1,294 Acute patient discharges 288 Newborn patient discharges 17 Swing bed patient discharges 82,945 Outpatient visits 70 Swing-bed patient days 434 Newborn patient days 53,440 Clinic visitsAvera Morningside Heights Care Center 26,818 Long-term resident days 179 Long Term Care patient dischargesAvera Marshall 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 $5,755,901.Avera Marshall 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 Marshall 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 Marshall 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$135,083,961TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document110IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee860EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jamie SchaeferBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6053223992PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13900 W Avera Dr Ste 300AddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57108ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Debbie Streier
Regional President & CEO40.006.00Yes (X)Yes (X)$0$489,400$17,435
George Jorgensen
Chair1.501.50Yes (X)Yes (X)$0$0$0
Amanda Sieling
Vice Chair1.501.50Yes (X)Yes (X)$0$0$0
Stephen Crim
Board Member/Ministerial Juridic1.5043.50Yes (X)$0$64,095$0
Quentin Fixen
Board Member1.501.50Yes (X)$0$0$0
Greg Goepferich
Board Member1.501.50Yes (X)$0$0$0
Sharon Hennen
Board Member1.501.50Yes (X)$0$0$0
Laurie Johansen
Board Member1.501.50Yes (X)$0$0$0
Sr Janice Klein
Board Member (End 02/2024)1.501.50Yes (X)$0$0$0
LaVonne Koenen
Board Member1.503.50Yes (X)$0$0$0
Curtis Louwagie MD
Board Member/Opthalmology41.501.50Yes (X)$846,339$0$57,633
Tim O'Leary
Board Member1.501.50Yes (X)$0$0$0
Joyce Strootman
Board Member1.501.50Yes (X)$0$0$0
Jill Vroman DO
Board Member/Family Medicine/OB41.501.50Yes (X)$510,393$0$50,971
Sr Jodie Zimmerman
Board Member1.501.50Yes (X)$0$0$0
Julie Lautt
CFO Avera Health;Secretary/Treasurer0.1046.30Yes (X)$0$1,203,675$19,401
Emmy Ho MD
Orthopedics & Surgery40.000.00$861,900$0$49,937Yes (X)
Daniel Lister MD
Orthopedics & Surgery40.000.00$838,382$0$45,097Yes (X)
Jonna Maas MD
Internal Medicine & Hospitalist40.000.00$768,315$0$49,234Yes (X)
Timothy Michals MD
Pediatrics & Internal Medicine40.000.00$695,654$0$17,435Yes (X)
Arthur Rillo MD
Family Medicine/OB40.000.00$717,909$0$50,241Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,238,892TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,757,170TotReportableCompRltdOrgAmt
Total Other Compensation$357,384TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K126IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Health
3900 W Avera DriveSioux FallsSD57108Shared Services$11,695,724
Big Stone Therapies Inc
500 Cross StBig Stone CitySD57216Therapy Services$4,939,634
AMN Healthcare Inc
2735 Collection Center DrChicagoIL60693Labor Services$1,779,020
Journey Group Companies
4500 W 58th StSioux FallsSD57108Construction Services$1,244,866
Janning ENT Center LLC
1801 19th Ave SWWillmarMN56201Labor Services$490,740
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K26CntrctRcvdGreaterThan100KCnt
Related Organizations$29,326RelatedOrganizationsAmt
Government Grants$378,531GovernmentGrantsAmt
Total Contributions$407,857TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Service Revenue621110$128,826,996$128,808,028$18,968
Federally Qualified Health Center621990$15,650,245$15,650,245
Pharmacy Revenue456110$1,766,825$1,766,825
Patient and Clinic Revenue621110$33,537$33,537

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,090,868TotalRevenueColumnAmt
Related Or Exempt Func Income$4,090,868RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$150,368,471TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$227,707TotalRevenueColumnAmt
Exclusion$227,707ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$102,762RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$8,977RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$93,785RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,785TotalRevenueColumnAmt
Exclusion$93,785ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$242,230SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$642OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$242,230SecuritiesAmt
Other-$642OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$241,588TotalRevenueColumnAmt
Exclusion$241,588ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
A/R Interest900099$63,915$63,915
Sports Programs900099$11,480$11,480
FieldValueIRS element (for citing)
Other Revenue Total$75,395OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$151,414,803TotalRevenueColumnAmt
Related Or Exempt Func Income$150,424,898RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$18,968UnrelatedBusinessRevenueAmt
Exclusion$563,080ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$35,813TotalAmt
Program Services$35,813ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,463,287TotalAmt
Program Services$1,463,287ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$55,748,382TotalAmt
Program Services$54,380,469ProgramServicesAmt
Management And General$1,367,913ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,893,068TotalAmt
Program Services$1,850,494ProgramServicesAmt
Management And General$42,574ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,634,393TotalAmt
Program Services$7,477,815ProgramServicesAmt
Management And General$156,578ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,526,995TotalAmt
Program Services$3,429,027ProgramServicesAmt
Management And General$97,968ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$121,995TotalAmt
Management And General$121,995ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$4,091TotalAmt
Management And General$4,091ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$34,772,323TotalAmt
Program Services$28,148,787ProgramServicesAmt
Management And General$6,623,536ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,502TotalAmt
Program Services$3,302ProgramServicesAmt
Management And General$3,200ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$704,310TotalAmt
Program Services$485,278ProgramServicesAmt
Management And General$218,862ManagementAndGeneralAmt
Fundraising$170FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$550,941TotalAmt
Program Services$545,980ProgramServicesAmt
Management And General$4,961ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,085,426TotalAmt
Program Services$1,757,283ProgramServicesAmt
Management And General$328,143ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$829,589TotalAmt
Program Services$822,384ProgramServicesAmt
Management And General$7,205ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$227,732TotalAmt
Program Services$206,532ProgramServicesAmt
Management And General$21,200ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$510,014TotalAmt
Program Services$423,247ProgramServicesAmt
Management And General$86,767ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,955,597TotalAmt
Program Services$5,367,401ProgramServicesAmt
Management And General$587,787ManagementAndGeneralAmt
Fundraising$409FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$518,443TotalAmt
Program Services$248,194ProgramServicesAmt
Management And General$270,249ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies$26,852,333$26,841,450$10,824$59
Equipment Lease/Rental$101,909$101,809$100
Provision for Income Ta$2,500$2,500

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,482,558TotalAmt
Program Services$1,492,909ProgramServicesAmt
Management And General$1,989,649ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$147,028,201TotalAmt
Program Services$135,083,961ProgramServicesAmt
Management And General$11,943,602ManagementAndGeneralAmt
Fundraising$638FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,177,591BOYAmt
EOY$1,033,965EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,199,316BOYAmt
EOY$17,564,495EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,132,295BOYAmt
EOY$3,306,368EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,402,764BOYAmt
EOY$1,178,532EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$115,459,251LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$66,068,567LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$49,118,791BOYAmt
EOY$49,390,684EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$17,239,490BOYAmt
EOY$23,641,781EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,416,664BOYAmt
EOY$1,756,599EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$350,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,014,224BOYAmt
EOY$3,380,607EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$91,701,135BOYAmt
EOY$101,603,031EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,567,236BOYAmt
EOY$11,014,307EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$62,024BOYAmt
EOY$210,809EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,805,303BOYAmt
EOY$12,283,499EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$23,070BOYAmt
EOY$11,681EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,918,327BOYAmt
EOY$4,699,787EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,375,960BOYAmt
EOY$28,220,083EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$63,455,740BOYAmt
EOY$69,361,923EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,869,435BOYAmt
EOY$4,021,025EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$67,325,175BOYAmt
EOY$73,382,948EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$91,701,135BOYAmt
EOY$101,603,031EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,386,602ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,190,077NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$481,094OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$4,091OtherActivitiesAmt
Total Lobbying Expenditures$4,091TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAvera Marshall paid dues to organizations which have a portion of the dues attributed to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$757,268BeginningYearBalanceAmt
Contributions$15,800ContributionsAmt
Investment Earnings Or Losses$74,883InvestmentEarningsOrLossesAmt
Other Expenditures$134,693OtherExpendituresAmt
End Year Balance$713,258EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$711,109BeginningYearBalanceAmt
Contributions$1,106ContributionsAmt
Investment Earnings Or Losses$49,515InvestmentEarningsOrLossesAmt
Other Expenditures$4,462OtherExpendituresAmt
End Year Balance$757,268EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$794,733BeginningYearBalanceAmt
Contributions$7,201ContributionsAmt
Investment Earnings Or Losses-$82,336InvestmentEarningsOrLossesAmt
Other Expenditures$8,489OtherExpendituresAmt
End Year Balance$711,109EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$685,848BeginningYearBalanceAmt
Investment Earnings Or Losses$119,848InvestmentEarningsOrLossesAmt
Other Expenditures$10,963OtherExpendituresAmt
End Year Balance$794,733EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$694,135BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,726InvestmentEarningsOrLossesAmt
Other Expenditures$5,561OtherExpendituresAmt
End Year Balance$685,848EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.65406PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.34594TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,004,636OtherCostOrOtherBasisAmt
Book Value$1,004,636BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$74,952,056OtherCostOrOtherBasisAmt
Depreciation$40,393,550DepreciationAmt
Book Value$34,558,506BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,393,430OtherCostOrOtherBasisAmt
Depreciation$24,731,768DepreciationAmt
Book Value$11,661,662BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,109,129OtherCostOrOtherBasisAmt
Depreciation$943,249DepreciationAmt
Book Value$2,165,880BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$49,390,684TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Avera Pooled Investments$19,300,373F
Interest in Avera Health Foundation$4,341,408F
FieldValueIRS element (for citing)
Total Book Value Securities$23,641,781TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Estimated Third-Party Payor Settlements$2,694,018
Right of Use Operating Lease Obligations$1,985,986
Other Liabilities$19,783
FieldValueIRS element (for citing)
Total Liability$4,699,787TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:The Organization holds funds on behalf of its residents.
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

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,163,494TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,163,494NetCommunityBenefitExpnsAmt
Total Expense0.01470TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,633,252TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,271,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,362,238NetCommunityBenefitExpnsAmt
Total Expense0.00930TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,796,746TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,271,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,525,732NetCommunityBenefitExpnsAmt
Total Expense0.02400TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$554,908TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$118,013DirectOffsettingRevenueAmt
Net Community Benefit Expns$436,895NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$343,436TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$343,436NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,633,411TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,941,943DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,691,468NetCommunityBenefitExpnsAmt
Total Expense0.06590TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$135,947TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$135,947NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,667,702TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,059,956DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,607,746NetCommunityBenefitExpnsAmt
Total Expense0.07210TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,464,448TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,330,970DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,133,478NetCommunityBenefitExpnsAmt
Total Expense0.09610TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$49,570TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$49,570NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$225,301TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$223,601NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,714TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,714NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$314,585TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$312,885NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Reimbursed By Medicare$23,877,143ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,115,451CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$761,692MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera Marshall Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 S Bruce StreetAddressLine1Txt
CityMarshallCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56258ZIPCd
FieldValueIRS element (for citing)
Website AddressSee Part V Section CWebsiteAddressTxt
State License00343StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other6 Provider Based ClinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Avera MarshallBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V Section COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Part V Section COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Avera MarshallPart V, Section B, Line 5: The Avera Marshall Regional Medical Center Community Health Needs Assessment (CHNA) was conducted in collaboration and partnership with community members, community organizations, stakeholders from local public health and internal stakeholders. These partners assisted in the development and analysis of assessment information through a series of data collection processes. In addition, Avera Marshall partnered with Southwest Health and Human Services (SWHHS) to provide a more comprehensive look into the social determinants of health and wellness in the communities we serve. SWHHS shared their draft of their 2019 Quality of Life Survey with us, which allowed us to incorporate the perspectives of 488 individuals on what defines a healthy community. In addition, we talked to 82 community members of diverse backgrounds and used a five member CHNA advisory committee that represented various aspects of our service area: academic, governmental, non-profit, industry, and vulnerable populations. Care was taken to consider the perspectives of the underserved populations - Karen, Hispanic/Latino, African American, and Somali. We also consulted with Vondie Woodbury of The Woodbury Group.
Avera MarshallPart V, Section B, Line 6a: The Avera Marshall region has three hospitals: Avera Marshall, Avera Tyler, and Avera Granite Falls. As it is that all three hospitals are in the Avera Health system, share equally the same demographic and geographic area, and have shared senior leadership, the conducted CHNA was a regional CHNA that was inclusive of all three hospitals. Additionally, the implementation plan established applies to all three facilities.
Avera MarshallPart V, Section B, Line 6b: Southwest Health and Human Services
Avera MarshallPart V, Section B, Line 11: A community health needs assessment was completed in FY2022. The following community health priority areas were identified: Cultural barriers that impact healthcare, including but not limited to interpretive services; Mental Health; and Transportation, as it relates to access for healthcare services. Avera Marshall Region, comprised of Avera Marshall, Avera Tyler and Avera Granite Falls, developed an implementation plan for each of these three priorities. Mental Health:Avera Marshall's goal around mental health will be to lower depression rates and engage in issues around suicide prevention. Partners we are working with: Public Health, Clergy, Community Groups, Southwest Mental Health, AMG general practice providers, schools, and AMG Mental health providers. Steps we are taking: - OB patients are being screened for mental health needs and connected to our mental health services as needed. - Avera Medical Group (AMG) tracks depression amongst our inpatient and outpatient Medicaid populations. - AMG providers discuss depression with patients who show signs of depression and help connect them with our mental health services. - Conducting a community wide suicide prevention campaign called, "Ask the Question" to provide community members information about how to talk to friends and family about suicide to reduce the risk of suicide. This program is engaging public health, providing education to church leaders, and delivering public service messages. - Our Karen community health worker is providing continuity of service for Karen patients referred to Southwest Mental Health. This continuity of service includes helping patients complete admitting paperwork and attending initial intake evaluation appointments. - Pediatric Patients and parents have the opportunity to participate in an approved Avera research study on pediatric mental health.Cultural barriers that impact healthcare, including but not limited to interpretive services:Avera Marshall's goal around cultural barriers is to improve interpretive services, aid in navigating the healthcare system, and educate our traditionally underserved populations in matters related to disease prevention and vaccinations. Partners we are working with: Public Health, Non-Avera Medical Providers, Churches, Community Groups, Local Employers, ARCH Language Network, and Avera Staff. Steps we are taking: - Updated Religious Community Contact List to include religions other than Christianity. - Books from various religious traditions added to chapel, Muslim prayer rug now available. - CMO and VP of Mission met with human resources and employee health at Turkey Valley Farms (employer of immigrant and refugee populations) to discuss how Avera and Turkey Valley Farms can improve access to health care for employees at Turkey Valley Farms. - CMO provides oversight for occupational health requirements at Turkey Valley Farms. - System health equity initiative established, and regional VP of Mission is assigned as health equity lead. - Quality and Mission joined a Program with Stratis Health that has the goal to help Critical Access Hospitals (CAH) better understand how to bring Social Determinants of Health (SDOH) into operations. - Clothed in Strength Program (clothing closet for patients who need clothing on discharge) is initiated and funding secured. This program will serve the most vulnerable in our community, including the ethnic populations where we see the most need for clothing. - Quality team to bring SDOH into their ongoing sepsis project. - Discussions begin on how quality initiatives can be included in the FY25 CHNA.Transportation, as it relates to access for healthcare services:Avera Marshall's goal is to improve transportation access for health care appointments for those who do not have transportation and develop stronger relationships with transportation services within our service area. Partners we are working with: Local and State Public Health, City of Marshall, United Community Action Partnership, Local Medical Transport Companies, and Avera Staff (Community Health Worker and Care Coordination). Steps we are taking: - Continued relationship with Southwest Minnesota Taxi to help with transportation needs that fall outside of other social services. - Karen community health worker provides transportation coordination for Karen community as needed. This allows care coordination to focus on more complex cases and will allow the community health worker to provide more targeted intervention on transportation for Karen community members. - When emergency medical transportation is utilized, providing clear directions to family and friends of the patient to the destination facility. Additionally, when those family and friends do not have transportation have social work/care coordination find a local transport company to bring at least one family member to the destination facility.There are needs identified in the Community Health Needs Assessment which Avera Marshall has not included in its priority implementation plan. These needs were not included in the priority needs implementation plan to focus resources on the three most urgent health care needs.The needs not being directly addressed in the CHNA implementation plan include: - Alcohol and drug abuse, - Access to cancer center screening, and - Issues related to aging problems.Though not in the implementation plan, we continue to address these needs throughout the Avera Marshall Region using the appropriate standards of care.
Avera MarshallPart 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 MarshallPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency room, 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 MarshallPart 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 MarshallPart 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.
Part V, Section B, Lines 7a, 7b and 10a:avera.org/about/community-health-needs-assessments/
Part V, section B, Line 16a-cThe FAP, FAP Application, and Plain Language Summary are available at:avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/
Part V, Section A website address:avera.org/locations/marshall/
FieldValueIRS element (for citing)
Facility11FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Avera Morningside Heights Care Center
300 S Bruce StreetMarshallMN56258Nursing home
2 - Avera Therapy Marshall
1521 Carlson StreetMarshallMN56258Physical, speech, and occupational therapy
3 - AMG Radiation Oncology
300 S Bruce StreetMarshallMN56258Clinic
4 - AMG Occupational Medicine
1521 Carlson StreetMarshallMN56258Clinic
5 - Avera Southwest Opthalmology - Montevideo
824 N 11th StMontevideoMN56265Optometry, ophthalmology
6 - AMG Optometry Redwood Falls
500 E Bridge StreetRedwood FallsMN56283Optometry, ophthalmology, optical
7 - AMG Optometry Tracy
505 State StreetTracyMN56175Optometry, ophthalmology, optical
8 - AMG Optometry Springfield
602 N Jackson AveSpringfieldMN56087Optometry, ophthalmology, optical
9 - Heartland Eye Care Center - Marshall
202 OConnell St Suite 1MarshallMN56258Optometry, optical
10 - Heartland Eye Care Center - Canby
130 1st St W Suite 105CanbyMN56220Optometry, optical
11 - Heartland Eye Care Center - Dawson
878 6th StDawsonMN56232Optometry, optical

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 actual expenses recorded to the general ledger. 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 provides education to community groups, has staff that serve on various committees/boards, pays the salaries of two police officers, provides leadership development and training for community members, and donates to various community organizations.
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 $2,099,472 was reduced for prior year reclassifications of $4,247,153 resulting in a net negative implicit price concession of $2,147,681. 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 concessions is located in the audited financial statement report on pages 19 and 20.
Part III, Line 8:Avera Marshall 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 programs 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:Avera Marshall uses many sources to assess the needs of the community, including their medical staff's daily interactions with their patients and the community. Additional sources include federal, state, and county statistical information, public health data, internal data, and input from community members, businesses, city, and other local agencies. To gain community member input the following processes are used: interviews, focus groups, neighborhood canvassing, and surveys. Other sources have included a CHNA advisory committee that included representatives from multiple service areas in the community, including academic, governmental, non-profit, industry, and vulnerable populations. Care is taken with all information sourcing to make sure we gain the perspective of the underserved populations: Karen, Hispanic/Latino, African American, and Somali. Avera Marshall also partners with many area organizations, including Southwest Health and Human Services (SWHHS,) where we share information, such as their Quality-of-Life survey.
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 Marshall is a 25-bed critical access hospital in Marshall, Minnesota, which includes an additional 10 behavioral health beds. The primary service area is defined as Lyon County, Minnesota, including the communities of Marshall, Minneota, Ghent, Taunton, Lynd, Russell, Cottonwood, Tracy, Balaton and Garvin. Marshall is the county seat. According to the U.S. Census Bureau Quick Facts 2023 data, the estimated population of Lyon County as of July 1, 2023 is 25,427 and is predominately white at 88.2%. It is estimated that 18.1% of the population is 65 years and over. The median household income is $68,919 with an 11.2% poverty rate. Uninsured individuals under age 65 is estimated at 5.5%.
Part VI, Line 5:Avera Marshall is one of the largest employers in the area and is committed to helping its community members get as much of their healthcare as close to home as possible. To this end, any surplus funds are reinvested in facilities to improve patient care, add/replace necessary equipment, and fund needed facility upgrades. To further ensure local care, medical staff privileges are extended to all qualified physicians in the community. E-care services are invested in monthly to ensure provider coverage is available locally via video conference to the patient's room or local provider office for emergency, behavioral health, ICU, pharmacy, and long-term care coverage.In addition, Avera Marshall is the sole provider for hospital inpatient care, the only physician staffed 24/7 ER Level III Trauma offering coverage no matter the ability to pay, birthing center, and full-service surgery center. Avera Marshall provides numerous services which do not produce a profit. An example of this is psychiatric services provided by the facility. This is a subsidized health service. Some of the other services include dialysis, in-home palliative care, and diabetic education.. Avera Marshall is committed to taking care of all individuals, no matter their ability to pay. Charity care is always available for those with a diminished ability to pay. We staff patient advocates, who meet with patients with high deductible plans and high-cost medications to find drug programs to help cover a patient's out of pocket costs. We also work with patients to complete presumptive Medicaid, full Medicare applications, answer questions on the MNSure insurance programs, help patients coordinate their insurance benefits and complete charity care applications for Avera and Access Health services. In addition, on January 1, 2022, Avera Marshall partnered with Rural Health Care Inc. to open Access Health-Marshall. This federally qualified health center clinic offers a full range of primary healthcare services. Avera Marshall offers a number of services that are free or low cost, including: childbirth classes, support groups, skin screening, Mother's Milk program (by purchasing donated breast milk and providing it to babies free of charge during their hospital stay), Planet Heart community screenings with reduced imaging fees in addition to free vein screenings, rape and sexual assault services not fully funded by the county, Hospice medical provider not billed to patients, sharps and unused medical disposal services, recycle eye wear program, transportation vouchers for patients without other options, physicals for sports are given to students who have no means to pay but wish to participate in athletic school activities, impact testing is provided to local schools to help support concussion testing and ensure student athletes do not return before they are ready, basic supply items are donated to school nurse providers for triage care, and in partnership with Big Stone Therapies, Avera Marshall provides athletic trainers to many high schools throughout the Marshall region with reduced cost to the school district. Avera Marshall also supports the local college, Southwest Minnesota State University with their medical needs for both students and athletes, including a medical director. Avera Marshall supports the local hockey program at the Red Baron Arena by providing volunteer medical coverage from local providers during weekend tournaments. This medical coverage for the facility must be EMT or higher. Community out-reach programs are done in partnership with local underserved communities and businesses. Avera hired a community health worker to support the Karen community by helping to coordinate their health needs and provide in-person interpretation services. In addition, virtual and other in person interpretation services are offered in several different languages. Staff Care Coordinators are also employed to help high-need patients navigate their health care needs. Educational experiences for school-aged children, students needing work study experience, and med student internships are offered. On an annual basis Avera Marshall provides scholarships for medical students and high-school students. Avera Marshall partners with Minnesota West Technical & Community College to provide free space within the hospital from some of their clinical training programs. Avera Marshall also partners with the Transition-to-Work Program or Project SEARCH. This program allows local high-school students with significant intellectual disabilities to be employed in nontraditional, complex, and rewarding jobs, allowing them to gain real-life work experience in order to achieve competitive employment upon graduation. The organization's governing body is comprised of volunteer members who reside in the community. Avera Marshall's leadership team, physicians, and general staff are encouraged to participate in civic and community organizations. Avera Marshall also offers many opportunities for community members to volunteer within the hospital, long term care, home care, hospice, and thrift store settings. Finally, to further safety for the community residents and patients, Avera funds two police officers for the City of Marshall. Avera Marshall's Thrift Store impacts the community in a variety of ways. The store donated approximately 80,000 pounds of fiber to Advanced Opportunities. Advanced Opportunities then sells the fiber to help support their programs, which at current fiber rates would be approximately $64,000. In addition, the store is able to donate to individuals in the community that cannot afford to pay for the items. The Thrift Store supports our judicial system by being an option for court ordered community service. The Thrift Store works with Project Turnabout to provide opportunities for those dealing with addiction to re-enter the workforce.
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

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Minnesota West Community & Technical CollegeBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11450 College WayAddressLine1Txt
CityWorthingtonCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56187ZIPCd
FieldValueIRS element (for citing)
Recipient EIN411687554RecipientEIN
IRC SectionGovernmentIRCSectionDesc
Cash Grant$0CashGrantAmt
Non Cash Assistance$34,118NonCashAssistanceAmt
Valuation Method UsedBook ValueValuationMethodUsedDesc
Non Cash AssistanceOperating Room BedNonCashAssistanceDesc
Purpose Of GrantEducation for surgical techsPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Julie Lautt
CFO Avera Health;Secretary/Treasurer$0$1,197,590$0$480$0$5,605$0$16,500$0$2,901$0$1,223,076$0$0
Emmy Ho MD
Orthopedics & Surgery$792,477$0$15,000$0$54,423$0$16,372$0$33,565$0$911,837$0$0$0
Curtis Louwagie MD
Board Member/Opthalmology$652,244$0$191,293$0$2,802$0$16,500$0$41,133$0$903,972$0$0$0
Daniel Lister MD
Orthopedics & Surgery$755,717$0$15,000$0$67,665$0$16,500$0$28,597$0$883,479$0$0$0
Jonna Maas MD
Internal Medicine & Hospitalist$365,371$0$366,444$0$36,500$0$16,500$0$32,734$0$817,549$0$0$0
Arthur Rillo MD
Family Medicine/OB$451,070$0$179,804$0$87,035$0$16,500$0$33,741$0$768,150$0$0$0
Timothy Michals MD
Pediatrics & Internal Medicine$668,209$0$26,212$0$1,233$0$16,500$0$935$0$713,089$0$0$0
Jill Vroman DO
Board Member/Family Medicine/OB$474,773$0$27,000$0$8,620$0$16,500$0$34,471$0$561,364$0$0$0
Debbie Streier
Regional President & CEO$0$481,234$0$440$0$7,726$0$16,500$0$935$0$506,835$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3:FormAndLineReferenceDesc
ExplanationPresident/CEO serves Avera Marshall, Avera Tyler, and Avera Granite Falls and was compensated by a related organization, Avera Health. Avera Marshall relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Julie Lautt and Debbie Streier have a business relationship. Julie Lautt and Stephen Crim have a business relationship.
Form 990, Part VI, Section A, line 6The 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 7aAvera 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 7bAvera 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 corporation; 2) To initiate the adoption, amendment or repeal of any provision of the articles of incorporation or bylaws of corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the member; 4) To approve any plan of merger, consolidation or dissolution of the corporation, or the divestiture of a sponsored work or ministry associated with the corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the corporation; 6) To appoint and remove, with or without cause, the board of directors of the corporation; 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the corporation; 8) To approve operating/capital budgets and strategic plans of the corporation; 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the member; 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the members; 11) To establish and maintain employee benefit programs; 12) To establish and maintain insurance programs; 13) To approve major community fund drives; 14) To approve the appointment of auditors; 15) To adopt policies designed to effectuate the reserved powers of the member.
Form 990, Part VI, Section A, line 8bThere are no committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe 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 12cThe 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 15bThe CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes.
Form 990, Part VI, Section C, line 19The organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 17,275,931. Management and general expenses 286,922. Fundraising expenses 0. Total expenses 17,562,853. Medical Professional Fees: Program service expenses 1,898,795. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,898,795. Repairs & Maintenance: Program service expenses 2,630,594. Management and general expenses 14,558. Fundraising expenses 0. Total expenses 2,645,152. Centralized Services: Program service expenses 6,343,467. Management and general expenses 6,322,056. Fundraising expenses 0. Total expenses 12,665,523.
Form 990, Part XI, line 9:Change in Interest in Avera Foundation 481,094.
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 Marshall.
Form 990, Part X, Line 20:The issue price includes the filing organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group 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. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 West Avera Drive Suite 300Sioux FallsSD57108460422673Healthcare ServicesSD501(c)(3)Line 10N/A0
Avera McKennan
1325 S Cliff Ave PO Box 5045Sioux FallsSD57117460224743Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera at Home
5300 S Broadband LaneSioux FallsSD57108460399291Home ServicesSD501(c)(3)Line 100Avera Health
Avera Health Plans Inc
3900 West Avera Drive Suite 101Sioux FallsSD57108460451539Health Financing and Health Plan AdminSD501(c)(4)0Avera Health
Avera Granite Falls
345 10th AveGranite FallsMN56241843156881Healthcare ServicesMN501(c)(3)Line 3Yes (1)Avera Marshall
Avera Tyler
240 Willow StreetTylerMN56178410853163Healthcare ServicesMN501(c)(3)Line 3Yes (1)Avera Marshall
Avera Queen of Peace Hospital
525 North FosterMitchellSD57301460224604Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera St Anthony's Hospital
300 N 2nd StreetONeillNE68763470463911Healthcare ServicesNE501(c)(3)Line 30Avera Health
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare ServicesSD501(c)(3)Line 30Avera Health
Avera Gettysburg
606 East GarfieldGettsyburgSD57442460234354Healthcare ServicesSD501(c)(3)Line 30Avera St Mary's
Avera Holy Family
826 N 8th StreetEsthervilleIA51334420680370Healthcare ServicesIA501(c)(3)Line 30Avera Health
Holy Family Hospital Foundation
826 N 8th StreetEsthervilleIA51334421317452Support of Health Related ServicesIA501(c)(3)Line 100Avera Holy Family
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare ServicesSD501(c)(3)Line 30Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare ServicesSD501(c)(3)Line 100Avera Health
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare ServicesSD501(c)(3)Line 30Avera Health

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
5300 S Broadband LaneSioux FallsSD57108820582350Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Lakes Regional Healthcare LLC
5300 S Broadband LaneSioux FallsSD57108862949748Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Sioux Center LLC
5300 S Broadband LaneSioux FallsSD57108753203100Medical Services - Home Medical EquipmentSDN/A00
Avera Home Medical Equipment of Spencer Hospital LLC
5300 S Broadband LaneSioux FallsSD57108800619999Medical Services - Home Medical EquipmentSDN/A00
Brookings Health System - Avera HME LLC
300 22nd AveBrookingsSD57006453204123Medical services - Home Medical EquipmentSDN/A00
Caravan Health ACO 15 LLC dba Prairie Vista Care Organization
4055 Valley View Lane Ste 700DallasTX75244611843657Accountable Care OrganizationTXN/A00
Caravan Health ACO 41 LLC dba Prairie View Care Organization
4055 Valley View Lane Ste 700DallasTX75244821447782Accountable Care OrganizationTXN/A00
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare ServicesSDN/A00
Surgical Associates Endoscopy Clinic LLC
310 S PennsylvaniaAberdeenSD57401460461429Surgical AssociatesSDN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Accounts Management Inc
5132 S Cliff Ave Suite 101Sioux FallsSD57108460373021Collection AgencySDN/AC0
Alucent Australia Pty Ltd
Biotech researchN/A0Level 10 30 Collings StreetMelbourneVIC 3000ASAS
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045Sioux FallsSD571175045471818349Biotech researchSDN/AC0
Avera Property Insurance Inc
1000 West 4th Street Suite 1YanktonSD57078460463155InsuranceSDN/AC0
DakotaCare Administrative Services Inc
5300 South Broadband LaneSioux FallsSD57108460424322InsuranceSDN/AC0
Kore Cares in Home Services LLC
5300 South Broadband LaneSioux FallsSD57108882278902In-home care servicesSDN/AS0
South Dakota State Medical Holding Company Inc
5300 South Broadband LaneSioux FallsSD57108460401087InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental real estateSDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other OrgYes (1)AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Avera Tyler
L$186,985General Ledger
Avera Granite Falls
L$472,183General Ledger
Avera Tyler
O$1,660,968General Ledger
Avera Granite Falls
O$3,089,343General Ledger
Avera Tyler
Q$64,762General Ledger
Avera Granite Falls
Q$269,298General Ledger
Avera Granite Falls
R$148,554General Ledger