2026-05-15T09:25:54-05:00 2025-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-07-01 843156881 Avera Granite Falls AVER 3205646200 345 10th Ave Granite Falls MN 56241 Julie Lautt CFO Avera Health 3205646200 2026-05-08 1 1 Kim Hunwardsen CPA P00484560 6122536500 2026-05-04 2024 2025-03-06 01:10:19Z Avera Granite Falls Health Center Debbie Streier 345 10th Ave Granite Falls MN 56241 31429469 0 X See Schedule O X 2019 MN Promotion of health 8 3 235 7 0 0 481084 222368 30247956 30508692 209007 663845 18066 22693 30956113 31417598 0 8025 0 0 15117316 15305324 0 0 0 13161276 14290457 28278592 29603806 2677521 1813792 30187089 34493938 10364844 11944169 19822245 22549769 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 and guided by Christian values. 0 0 25192332 8025 30520832 Avera Granite Falls' mission is to provide healthcare services to Granite Falls, Minnesota residents and residents of the surrounding area. Avera Granite Falls is a 501(c)(3) organization affiliated with Avera Health and controlled by Avera Marshall. Avera Granite Falls consists of a 25-bed critical access hospital, a 48-bed nursing home, a 28-unit senior living facility in Granite Falls, Minnesota, and one physician clinic. The program services offered include primary care, med/surg, lab, imaging, physical therapy, speech therapy, occupational therapy, respiratory therapy, ambulance, special transportation, ER, telehealth, infusion, general surgery, chemotherapy, cardiac rehab, long term care and independent living. Following is a breakdown of these statistics by facility:Avera Granite Falls Health Center 102 Acute patient discharges 53 Swing bed patient discharges 19,112 Outpatient visits 445 Swing-bed patient days 18,232 Clinic visitsAvera Granite Falls Care Center 17,083 Long-term resident days 40 Long Term Care patient dischargesAvera Granite Falls 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 $468,358.Avera Granite Falls 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 Granite Falls 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 Granite Falls 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. 25192332 1 1 0 1 0 0 0 0 1 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 41 0 1 235 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 3 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1274363 20218 Debbie Streier Regional President & CEO 2.00 44.00 X X 0 578020 18180 Rosa Rios Avendano MD Board Member/Family Medicine/OB 2.00 40.00 X 0 343861 36520 Thomas Kooiman Board Member/Administrator 42.00 0.00 X X 313271 0 37926 Deena Aus Director - Patient Care Services 40.00 0.00 X 149612 0 45944 Jennifer Ann Jager Director - Ambulance 40.00 0.00 X 137661 0 18774 Seth Streblow Assistant Director - Ambulance 40.00 0.00 X 120960 0 29119 Troy L Mansell Radiology Technologist II 40.00 0.00 X 120529 0 9134 Jennifer Varpness RN - Clinical Informaticist 40.00 0.00 X 119231 0 18582 Stephen Crim Board Member/Ministerial Juridic 1.00 43.00 X 0 57309 0 LaVonne Koenen Chair 2.00 3.00 X X 0 0 0 Mark Jensen Board Member 2.00 0.00 X 0 0 0 Sister Lucille Welbig Board Member/System Member 2.00 10.00 X 0 0 0 Dan Barber Board Member 1.00 0.00 X 0 0 0 961264 2253553 234397 15 0 1 0 Avera Health 3900 W Avera Drive Sioux Falls SD 57108 Shared Services 2557447 Big Stone Therapies Inc 500 Cross St Big Stone City SD 57216 Therapy Services 1025525 Central Minnesota Diagnostic Inc PO Box 64756 St Paul MN 55164 Radiology Services 326406 AMN Healthcare Inc 2735 Collection Center Dr Chicago IL 60693 Contracted Services 246036 Heart Institute of North Dakota 1191 S Columbia Rd Grand Forks ND 58201 Contracted Services 217002 6 38025 184343 222368 Net Patient Revenue 621110 28315951 28315951 Pharmacy Revenue 456110 1637782 1637782 Patient and Clinic Revenue 621110 110572 110572 444387 444387 30508692 785 785 22424 11871 10553 10553 10553 662960 100 0 0 662960 100 663060 663060 A/R Interest Income 900099 12140 12140 12140 31417598 30520832 0 674398 X 8025 8025 355290 355290 111953 111953 11777579 11580244 197335 430930 425988 4942 1785756 1771592 14164 843816 833678 10138 330 330 6942766 4999077 1943689 5788 3384 2404 366041 147745 218296 173566 173476 90 682246 579985 102261 136379 127939 8440 49638 42106 7532 881901 566229 315672 131578 100 131478 Medical Supplies 3445185 3441309 3876 Equipment Lease/Rental 16691 16691 1458348 362811 1095537 29603806 25192332 4411474 0 -507195 48673 3588605 3573543 350979 362287 177177 205282 7469851 4646428 2963247 2823423 14074605 17965929 104628 117338 9435043 9397463 30187089 34493938 1659148 1601352 95690 291745 8832 5759 8948819 8601174 1096494 10364844 11944169 X 19587046 22252919 235199 296850 19822245 22549769 30187089 34493938 X 1813792 844198 69534 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 1 330 330 0 Part II-B, Line 1: Avera Granite Falls paid dues to organizations which have a portion of the dues attributed to lobbying activities. 0 1 X 363983 64367 299616 6607667 4246734 2360933 498201 335327 162874 2823423 Avera Pooled Investments 17272412 F Investments in Affiliated Organizations 366568 F Interest in Avera Health Foundation 326949 F 17965929 Right of Use Asset 9202862 Intercompany Assets 194601 9397463 Intercompany Payables 436469 Right of Use Operating Lease Obligations 478392 Security Deposits 12159 Third Party Payor Settlements 169474 1096494 X Part IV, Line 2b: The Organization holds funds on behalf of its residents. 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 184827 184827 0.00620 3948482 3779928 168554 0.00570 4133309 3779928 353381 0.01190 10635 10635 0.00040 21355 21355 0.00070 10247888 7062205 3185683 0.10760 14452 14452 0.00050 10294330 7062205 3232125 0.10920 14427639 10842133 3585506 0.12110 12730 5865 6865 0.00020 12730 5865 6865 0.00020 1 420720 2141838 2140532 1306 X 1 1 1 1 Avera Granite Falls 345 10th Avenue Granite Falls MN 56241 See Part V 395031 X X X X 1 Provider Based Clinic Avera Granite Falls 1 0 0 1 X X X X X X X X X 24 1 1 1 1 X See Part V Section C X See Part V Section C X 1 24 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 Granite Falls Part V, Section B, Line 5: To develop the 2025 Community Health Needs Assessment (CHNA), the Avera Marshall Region gathered input directly from community members, public health representatives, and local organizations across Lincoln, Lyon, Chippewa, and Yellow Medicine counties. Feedback was collected through surveys, focus groups, and partnerships with local agencies to ensure that diverse voices were represented, including medically underserved and minority populations.A community survey consisting of eight questions was available for four weeks in March 2025, both online and in paper format. The paper version was distributed at the Avera Marshall Thrift Store and translated into Spanish to improve accessibility. A total of 154 residents completed the survey, sharing perspectives on personal and community health, barriers to care, and ideas for improvement.Two focus groups provided deeper insight into community needs. One group, held in April 2025, included members of the white ethnic community representing education, law enforcement, and social services. The second, held in December 2024, included women from the Karen community, one of the largest minority groups in the region. Participants discussed mental health, transportation, access to care, interpreter services, and provider communication.In addition, Southwest Health and Human Services (SWHHS) shared its 2024 health report and provided input on community health priorities. Input was also gathered from community health workers, faith leaders, and local employers of minority populations. Avera Granite Falls Part 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 Granite Falls Part V, Section B, Line 6b: Southwest Health and Human Services Avera Granite Falls Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Cancer - Dental Health - Mental HealthThe Avera Marshall Region developed a three-year implementation strategy to address priority health needs identified through the FY2025 Community Health Needs Assessment (CHNA). The plan focuses on cancer, dental health, and mental health, with goals, resources, community partners, and measurable outcomes defined for each area.Cancer initiatives aim to keep patients closer to home, expand access to research trials, develop a high-risk breast cancer clinic, and increase education and fundraising for cancer care.Dental health goals include building partnerships with local dentists, providing oral health education through community health workers, and distributing dental kits to schools and local nonprofits.Mental health strategies emphasize collaboration with schools, social service agencies, and local organizations to strengthen youth and adolescent support, expand access to care, recruit staff, and develop creative therapeutic programs.Progress will be reviewed annually and shared in the next CHNA cycle. The implementation plan was approved by the boards of Avera Marshall, Avera Tyler, and Avera Granite Falls in September 2025 and is publicly available on the Avera website.Avera Granite Falls will not be directly addressing other areas of concern, such as aging problems, domestic violence and child abuse, heart disease, obesity, and housing issues, identified through the assessment process. While the leadership team recognizes that other concerns exist, the hospital does not have the resources or expertise to address at this time.Avera Granite Falls continued to address the community health needs identified in the community health needs assessment completed in FY2022. Avera Granite Falls maintained its implementation plan for the following priorities 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. Mental Health: Avera Granite Falls' 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 taken: - The Avera Medical Group continues to track mental health needs among inpatient and outpatient populations. Providers regularly discuss depression with patients and integrate mental health screening into ongoing service lines, including routine OB care. These actions reflect an enduring commitment to early detection, continuity of care, and integrated behavioral health across departments. - The Avera Marshall region continued its "Ask the Question" initiative with a sustained focus on supporting the mental health of veterans. - 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 can participate in an approved Avera research study on pediatric mental health. Cultural barriers that impact healthcare, including but not limited to interpretive services:Avera Granite Falls' 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 taken: - Avera maintains a continuous effort to expand access to in-person interpretation services for patients with limited English proficiency, recognizing the importance of cultural and linguistic responsiveness in health care. Efforts include having a Spanish speaking provider to provide in-person services, partnerships with Language Line and communication initiatives targeting Hispanic and Karen community members. - A Karen Community Health Worker (CHW) and Hispanic CHW continue to play an active role in outreach, health education, and interpretation. The CHW's certification and ongoing engagement exemplifies Avera's long-term commitment to cultural competency and equitable access to care. - Updated Religious Community Contact List to include religions other than Christianity. - Books from various religious traditions added to the chapel, Muslim prayer rug now available. - Avera Marshall Region is developing a health promotion program for employees at the local meat processing facility in Marshall, Minnesota, which employs approximately 450 workers representing diverse ethnic communities, including Karen, Somali, and Hispanic populations. The program is being designed to address diabetes prevention and management among this workforce, who experience multiple social determinants of health challenges such as limited access to care, language barriers, and high occupational stress. - 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 join a Program with Stratis Health that has the goal to help CAH better understand how to bring Social Determinants of Health (SDOH) into operations. - The Clothed in Strength Program continues to operate year-round, providing essential clothing and supplies to patients in hospitals, long-term care facilities, and the broader community through the Avera Thrift Store. - The Dispensary of Hope project remains active regionwide, ensuring that low-income patients continue to have access to necessary medications through a sustainable, charitable distribution system. - The Avera Thrift Store collaborated with a wide network of local and international nonprofits, schools, faith communities, and service organizations to distribute clothing, household goods, and supplies to those experiencing need:Partner organizations included WRAP, UCAP, Central Africa Mission, Nan's Knits, Boulder Creek Assisted Living, Parkside Elementary, the Nigeria Supply Program (via Canby Catholic Church), Avera Tyler Sunrise Manor, Marshall Animal Clinic, Avera Marshall Behavioral Health Unit, Habitat for Humanity, Marshall High School, Lutheran World Relief, the Marshall High School Tennis Team, Go Creations, Reunited Halfway House, Southwest Health and Human Services, Western Mental Health, the Tyler Arts Council, Avera Morningside Heights, Holy Redeemer Catholic Church, Phase Industries, the Lyon County Master Gardeners, the Lakeside Companion Animal Clinic, Our Savior's Lutheran Church in Canby, Saint Edward's School, Saint Mary's Church, Canby Hospital, the Marshall Middle School Kindness Closet, Friends of the Library, Awake Journey, and Disabled American Veterans. Through these partnerships, the organization distributed a wide range of materials including clothing, shoes, blankets, towels, craft supplies, kitchenware, school items, vases, and sunglasses to support individuals and families in need, immigrants, students, and those in care facilities. Notable donations included 500 pairs of children's sunglasses to local parochial schools, 24 pairs of shoes to Disabled American Veterans, and CD players to hospice patients - Quality team to bring SDOH into their ongoing sepsis project. - The Avera Marshall Region continues several initiatives designed to provide lasting improvements in health access, equity, and community well-being. - New partnerships were initiated with leaders of the local Muslim community to explore culturally sensitive health promotion programs.Continued at end of Schedule H, Part V narratives. Avera Granite Falls 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 Granite Falls Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, andAvera Granite Falls admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. Avera Granite Falls 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 ofassistance. 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 Granite Falls 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 A organization's website: avera.org/locations/avera-granite-falls-health-center/ Part V, Section B, Lines 7a, 7b and 10a: avera.org/about/community-health-needs-assessments/ Schedule H Part V, Lines 16a, 16b, and 16c: avera.org/patients-visitors/pay-my-bill-online/financial-assistance-programs/ Part V, Section B, Line 11 (Cont'd): Transportation, as it relates to access for healthcare services:Avera Granite Falls' 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 taken: - Avera continues collaboration with the City of Marshall and public health partners to improve transportation access, including the addition of a bus stop at the Federally Qualified Health Center (FQHC) and partnerships with other agencies to ensure reliable transportation for medical appointments. These efforts represent a sustained commitment to addressing transportation as a social determinant of health. - 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, we have social work/care coordination find a local transport company to bring at least one family member to the destination facility. - Avera Marshall Region applied for a grant to expand special transportation services through Granite Falls Ambulance, with availability extending to the broader Marshall & Tyler communities. 2 1 - Avera Granite Falls Care Center 250 Jordan Dr Granite Falls MN 56241 48-bed Skilled Nursing Facility 2 - Avera Granite Ridge Senior Living 500 Skyview Dr Granite Falls MN 56241 28-unit Independent Living Apartments Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 6a: The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/. Part I, Line 7: Charity care was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost report. Subsidized health services were calculated based on a combination of the Medicare cost report and actual expenses recorded to the general ledger. Community health improvement services and health professions education are reported based on actual expenses recorded to the general ledger. Cash and in-kind contributions are reported based on actual expenses recorded in the general ledger. Part II, Community Building Activities: Avera Granite Falls participates in nonprofit organizations for the betterment of the community. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 18 and 19. Part III, Line 8: Avera Granite Falls 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 Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. Part VI, Line 2: Avera Granite Falls 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, community health workers for the Karen and Spanish communities, neighborhood canvassing, and surveys. Other sources have included a Mission and Planning Committee and our full governing board that includes 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 Region also partners with many area organizations, including Southwest Health and Human Services (SWHHS), where we share information, such as their annual Health Report. 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 Granite Falls is a 25-bed critical access hospital in Granite Falls, Minnesota. The primary service area is defined as Chippewa and Yellow Medicine Counties, Minnesota, including the communities of Granite Falls, Hanley Falls, Cottonwood, Wood Lake, Echo, Sacred Heart, Maynard, and Clarkfield. Granite Falls is the county seat of Yellow Medicine County. According to the U.S. Census Bureau Quick Facts 2025 data, the estimated population of Yellow Medicine County as of July 1, 2024 is 9,373 and is predominately white at 91.2%. It is estimated that 23.2% of the population is 65 years and over. The median household income is $74,000 with a 9.8% poverty rate. Uninsured individuals under age 65 is estimated at 5.6%.According to the U.S. Census Bureau Quick Facts 2025 data, the estimated population of Chippewa County as of July 1, 2024 is 12,299 and is predominately white at 90.6%. It is estimated that 22.1% of the population is 65 years and over. The median household income is $71,458 with a 12.4% poverty rate. Uninsured individuals under age 65 is estimated at 7.2%. Part VI, Line 5: Avera Granite Falls 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. Investments are made monthly to bring e-care services to the community so even if emergency, pharmacy, and long-term care specialists are not on site, they can be televised into the patient's room or local nursing/provider office. To further ensure local care, medical staff privileges are extended to all qualified physicians in the community.In addition, Avera Granite Falls is the sole provider for hospital inpatient care, the only 24/7 ER offering coverage no matter the ability to pay and surgery center. As a result of the mission statement, Avera Granite Falls provides numerous services which do not produce a profit. An example of this is Special Transportation Services (STS), local 911 ambulance service, and 24/7 fully staffed emergency center. Avera Granite Falls is committed to taking care of all individuals, no matter their ability to pay. Financial assistance is always available for those with a diminished ability to pay. We have staff available, 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. They 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 financial assistance applications for Avera. Avera Granite Falls pays the 1.8% MN Care Tax on gross receipts that the State of MN uses to fund the MinnesotaCare program, a state health care program for Minnesotans with low incomes. Avera Granite Falls offers a number of services that are free or low cost, including: MN Vaccine for Children program to insure access to child vaccinations for all children ages 0-19 regardless of ability to pay, 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, standby ambulance at local football games, and in partnership with Big Stone Therapies, Avera provides athletic trainers to many high schools throughout the region with reduced cost to the school district. Avera also participates in community health events. Community out-reach programs are done in partnership with local underserved communities and businesses. Avera supports the Upper Sioux Community by collaborating with initiatives like covid shots, provider CPR and First Responder Training, and EMR classes to the Upper Sioux Police. Avera Granite Falls also volunteers Ambulance hours to the Upper Sioux at their weekend long Pow Wow. In addition, virtual and other in person interpretation services are offered in several different languages. Plus, employees are being cross trained to help with medical interpretation for patients that speak Spanish, Karen, and Somali. Staff Care Coordinators are also available to help high need & high-risk patients navigate their health care needs, as well as follow-up after discharge. Educational experiences for school-aged children, students needing work study experience, and med student internships are offered, and educational classes are held for CPR. On an annual basis Avera provides scholarships for medical students and high-school students. Avera Granite Falls works closely with the Southwest Private industry Council and Minnesota West to promote early exposure to healthcare careers. In addition, Avera participates with Granite Falls Kiwanis in a Reach Out and Read program which promotes early literacy for children ages 4 months to 5 years.The organization's governing body is comprised of volunteer members who reside in the community. Avera Granite Falls' leadership team, physicians, and general staff are encouraged to participate in civic and community organizations. Avera also offers many opportunities for community members to volunteer within the hospital, long term care, home care, and hospice settings. 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. 0 0 0 0 0 0 0 0 0 Julie Lautt CFO Avera Health;Secretary/Treasurer 0 1226098 0 41964 0 6301 0 17250 0 2968 0 1294581 0 0 Debbie Streier Regional President & CEO 0 550926 0 18936 0 8158 0 17250 0 930 0 596200 0 0 Rosa Rios Avendano MD Board Member/Family Medicine/OB 0 275906 0 55365 0 12590 0 9717 0 26804 0 380382 0 0 Thomas Kooiman Board Member/Administrator 311862 0 0 0 1409 0 7419 0 30507 0 351197 0 0 0 Deena Aus Director - Patient Care Services 142768 0 1255 0 5589 0 8039 0 37905 0 195556 0 0 0 Jennifer Ann Jager Director - Ambulance 125248 0 12330 0 83 0 6983 0 11790 0 156434 0 0 0 Seth Streblow Assistant Director - Ambulance 111575 0 8006 0 1379 0 2509 0 26610 0 150079 0 0 0 Schedule J, Part I, Line 3: The President/CEO serves Avera Marshall, Avera Tyler, and Avera Granite Falls and was compensated by a related organization, Avera Health. Avera Granite Falls relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. McKenzie Finke Family member of board member 111953 Employee compensation and benefits 0 Form 990, Item J: The organization's website is: avera.org/locations/avera-granite-falls-health-center/ Form 990, Part VI, Section A, line 2 Julie Lautt, Sr Lucille Welbig and Debbie Streier have a business relationship. Julie Lautt, Sr Lucille Welbig and Stephen Crim have a business relationship. Julie Lautt, Debbie Streier, LaVonne Koenen, and Rosa Roja Rios Avendano MD have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the Corporation is Avera Marshall, a nonprofit corporation organized and existing under the laws of the State of Minnesota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera Marshall 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 Marshall, the Member of Avera Granite Falls, has the exclusive right: 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of the Corporation, provided that any such amendments or repeal shall be consistently applied systemwide to all similarly situated affiliates of the Member. 2) To approve the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of the Corporation; provided that any such amendments impacting the composition or powers of the Board of Directors of the Corporation, including its Community Directors, shall be recommended or approved by a supermajority of the Board of Directors pursuant to Section 4.14. 3) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 4) To appoint and remove members of the Board of Directors of the Corporation recommended for appointment by the Governance Committee and the Board of Directors; provided that (i) the Member's exercise of its approval authority with respect to a candidate for Community Director shall be considerate of the recommendation made by the Board of Directors and may not be arbitrarily or unreasonably withheld; and (ii) an appointed Community Director may not be removed by the Member absent the Community Director's significant illegal conduct, or conduct by or status of the Community Director that causes clear jeopardy to the corporation's continuing exemption under Section 501(c)(3) of the Internal Revenue Code. 5) To appoint and/or remove, with or without cause, the Administrator of the Corporation, subject to: (i) prior mutual agreement between the Member and the Board of Directors regarding the process of selecting the Administrator; (ii) the approval by the Board of Directors of the candidate proposed by the Member for appointment to be Administrator; and (iii) consultation by the Member with the Board of Directors prior to the Member's removal of the Administrator. Notwithstanding the foregoing and any other provision of these Bylaws to the contrary, if after consulting with the Member, the Board of Directors determines to remove the Administrator, then the Member will carry out such removal following such consultation. 6) To approve operating/capital budgets and strategic plans of the Corporation following a recommendation of the Board of Directors. 7) To approve expenditures recommended by the Board of Directors outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 8) To approve any acquisitions, merger, consolidation, liquidation, or dissolution of the Corporation (including the plan of dissolution), sale or lease, or other transfer, or mortgage or other grant of security interest (except as pledged through Section 2.2(o) and (p)), of or in, all or substantially all of the assets of this Corporation, following a recommendation of a supermajority of the Board of Directors pursuant to Section 4.14. 9) To establish and maintain employee benefit programs. 10) To establish and maintain insurance programs. 11) To approve major community fund drives. 12) To approve the appointment of auditors. 13) To adopt policies designed to effectuate the reserved powers of the Member not inconsistent with these Bylaws. 14) To initiate and give final approval to equity and asset transfers by and between the Member and the Corporation and any affiliates or subsidiaries of the Member; provided that any such transfers in excess of $1,000,000 per year from the Corporation shall be approved by a supermajority of the Board of Directors pursuant to Section 4.14. 15) To initiate and give final approval to (i) any and all issuances of obligations under any existing or future master indentures binding the Corporation, any indebtedness (including, without limitation, capitalized leases) in excess of dollar thresholds as may be from time to time established by the Member, and (ii) any pledges of collateral for such indebtedness and any pledges of real estate as collateral for any indebtedness regardless of amount. 16) Full and exclusive power to: (i) execute supplemental master indentures, including, without limitation, those authorizing the issuance of obligations or series of obligations, (ii) full and exclusive power to prepare, or authorize the preparation of, any and all documents, agreements, swap agreements, investment contracts, certificates and disclosure materials (including, without limitation, Official Statements and any supplements thereto) reasonably and ordinarily prepared in connection with the issuance of obligations thereunder, or related bonds associated therewith and to execute and deliver such items to the appropriate parties in connection therewith, and (iii) full and exclusive power to authorize the entrance of members to, or withdrawal of members from, any obligated group, subject to the other requirements of the applicable master indenture for such entrance or withdrawal. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. 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 CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of the Caring for Life Catholic Health Ministries Members of Avera Health, 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. Depending on the individual's role with the organization, some officers are compensated by Avera Granite Falls. Form 990, Part VI, Section C, line 19 The Organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public. Form 990, Part IX, line 11g Purchased Services: Program service expenses 3,211,098. Management and general expenses 59,093. Fundraising expenses 0. Total expenses 3,270,191. Medical Professional Fees: Program service expenses 190,056. Management and general expenses 0. Fundraising expenses 0. Total expenses 190,056. Repairs & Maintenance: Program service expenses 598,713. Management and general expenses 79,370. Fundraising expenses 0. Total expenses 678,083. Centralized Services: Program service expenses 999,210. Management and general expenses 1,805,226. Fundraising expenses 0. Total expenses 2,804,436. Form 990, Part XI, line 9: Change in Interest in Avera Foundation 7,884. Change in Assets with Donor Restrictions 61,650. 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 Granite Falls. Form 990, Part X, Line 20: Avera Granite Falls 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 Granite Falls was not allocated any share of the bond issue, and thus does not have an amount on line 20. Avera Health 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460422673 Healthcare services 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 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing & health plan admin SD 501(c)(4) Avera Health 1 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 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 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 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 0 Holy Family Hospital Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 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 100 22nd Ave Suite 101 Brookings SD 57006 453204123 Healthcare Services SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 20 Burton Hills Blvd Ste 100 Nashville TN 37215 611843657 Accountable Care Organization MO N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 20 Burton Hills Blvd Ste 100 Nashville TN 37215 821447782 Accountable Care Organization MO N/A 0 0 Heart Hospital of South Dakota LLC 4500 W 69th Street Sioux Falls SD 57108 562143771 Healthcare Services NC N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Penn Aberdeen SD 57401 460461429 Surgical associates SD N/A 0 0 Accounts Management Inc 5132 S Cliff Ave 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 Company 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 0 0 0 1 1 1 1 1 1 1 Form 990, Schedule R, Part II, Tax Exempt Organizations: Holy Family Hospital Foundation dissolved November 2024. Form 990, Schedule R, Part IV, Corporation or Trust: Valley Health Services dissolved June 2025. Alucent Biomedical, Inc. dissolved May 2025. Alucent Australia Pty Ltd dissolved May 2025.