2024-05-14T15:18:18-05:00 2023-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-07-01 460234354 Avera Gettysburg AVER 6057652488 606 East Garfield Gettysburg SD 57442 Julie Lautt CFO Avera Health 6057652488 2024-05-08 1 Julie Lautt XXX-XX-XXXX 1 Kim Hunwardsen CPA P00484560 6122536500 2024-04-30 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Avera Missouri River Health Center Shantel Krebs 606 East Garfield Gettysburg SD 57442 12778709 0 0928 X See Schedule O X 1952 SD Promotion of health 12 9 114 9 0 0 597648 166101 11666716 12560688 14856 51881 4213 39 12283433 12778709 5171 1822 0 0 6315036 6551467 0 0 0 5312421 6216674 11632628 12769963 650805 8746 17011211 24541675 3748405 10402418 13262806 14139257 X Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. 0 0 11295471 1822 12560727 Avera Gettysburg's mission is to provide healthcare services to Gettysburg, South Dakota residents and residents of the surrounding counties including Potter, Sully Faulk, and Dewey. Avera Gettysburg is a 501(c)(3) organization affiliated with Avera Health. Avera Gettysburg consists of a 7-bed critical access hospital, a physician clinic, and a 53-bed nursing home in Gettysburg, South Dakota. Avera Gettysburg provides acute care, swing-bed, and long-term healthcare services. Services include emergency department, surgery, x-ray, laboratory, CT, outpatient treatment, physical therapy, occupational therapy, ambulatory care, long-term care, and senior living apartments. Following is a breakdown of these statistics by facility:Avera Gettysburg Hospital 80 Acute patient discharges 45 Swing Bed patient discharges 5,390 Outpatient visits 472 Swing-bed patient days 4,597 Clinic visitsOahe Manor 11,337 Long-term resident days 22 Long Term Care patient dischargesAvera Gettysburg 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 $98,775.Avera Gettysburg 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 Gettysburg 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 Gettysburg 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. 11295471 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 114 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 9 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Shantel Krebs Interim President/CEO (Beg 03/2023) 2.00 42.00 X X 0 107215 5497 Dr Mikel Holland CMO/President/CEO (End 03/2023) 2.00 42.00 X X 0 397658 54210 Mike Weisgram Chair 2.00 2.00 X X 0 0 0 Kristin Brost Board Member 2.00 2.00 X 0 0 0 Jamie Cronin Board Member 2.00 2.00 X 0 0 0 Dr Mark Hagy Board Member/Orthopedics 2.00 42.00 X 0 827282 29930 Michael Larson Board Member 2.00 2.00 X 0 0 0 Meredith Lee Board Member 2.00 2.00 X 0 0 0 Kim Olson Board Member 2.00 2.00 X 0 0 0 Rena Robbennolt Beg 032023 Board Member/Nurse Practioner 30.00 2.00 X 27887 67154 42943 Sr Lynn Marie Welbig PBVM Board Member 2.00 3.00 X 0 0 0 Robert Wylie Board Member 2.00 2.00 X 0 0 0 Sr Penny Bingham Board Member 2.00 7.00 X 0 0 0 Dr Amy Lueking - Board mbr to 03/2023)/VP of Med Affairs/CMO 2.00 42.00 X 0 327482 49050 Julie Lautt CFO Avera Health;Secretary/Treasurer 0.10 46.30 X 0 1086452 17088 Connie Belford Nurse Practitioner 40.00 0.00 X 165495 0 41562 Mary Mae B Quipot-Ackerman Medical Lab Scientist 40.00 0.00 X 112726 0 7505 Jonda Sue Johnson Director - Patient Care 40.00 0.00 X 115173 0 29259 Kristi Livermont MBA Administrator 40.00 0.00 X 134679 0 17882 Daylon Wigart Nurse Practitioner 40.00 0.00 X 166070 0 40073 Todd Forkel Former President/CEO 0.00 0.00 X 0 113998 11419 722030 2927241 346418 6 1 1 0 0 51620 114481 166101 Patient Service Revenue 621110 11914520 11914520 Pharmacy Revenue 456110 558382 558382 Patient and Clinic Revenue 621110 26327 26327 61459 61459 12560688 8282 8282 43599 0 43599 43599 43599 A/R Interest 900099 39 39 39 12778709 12560727 0 51881 X 1822 1822 109694 109694 4978453 4754480 223973 183518 171922 11596 927088 898774 28314 352714 335130 17584 344 344 497 497 3246114 2395281 850833 5569 2673 2896 122622 65525 57097 44755 43265 1490 223053 206107 16946 40630 32141 8489 16586 16586 917226 716520 200706 32559 32559 Medical Supplies 1431137 1428817 2320 Equipment Lease/Rental 7281 7281 128301 109109 19192 12769963 11295471 1474492 0 10931 22076 1292596 1427493 173098 120653 27479 29517 18104368 6482739 12100533 11621629 3406574 10455036 109041 0 756230 17011211 24541675 465806 432752 2252 933 3704 1548 3276643 9967185 3748405 10402418 X 13262806 13674328 464929 13262806 14139257 17011211 24541675 X 8746 390788 476917 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 1 497 497 0 Part II-B, Line 1: Avera Gettysburg paid dues to organizations which have a portion of the dues attributed to lobbying activities. 0 1 X 325295 325295 14497089 4528007 9969082 65459 65459 0 2799996 1752940 1047056 416529 136333 280196 11621629 Avera Pooled Investment Fund 9668338 F Interest in Avera Health Foundation 786698 F 10455036 Intercompany Liabilities 9963755 Security Deposit 3430 9967185 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 87000 87000 0.00680 214462 183403 31059 0.00240 301462 183403 118059 0.00920 8363771 4152137 4211634 0.32980 1299 1299 0.00010 8365070 4152137 4212933 0.32990 8666532 4335540 4330992 0.33910 1 145874 3874430 3899224 -24794 X 1 1 1 1 Avera Gettysburg Hospital 606 East Garfield Gettysburg SD 57442 See Part V Section C 10542 X X X Provider based clinic Avera Gettysburg Medical Center 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V Section C X See Part V Section C X 1 21 1 See Part V Section C 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X see Part V Section C X see Part V Section C X see Part V Section C X X X X X X X 1 X 0 X X X X X 1 X 0 0 Avera Gettysburg Medical Center Part V, Section B, Line 5: Avera Gettysburg conducted a focus group in November 2021 to gain input on the current and future community health needs. The group included community leaders from ministerial communities, health care, emergency medical services (EMS) and local law enforcement, governance members-representing a voice of the poor and various business members of the community. Vilas Pharmacy, Whitlock Bay Economic Development Corp., Gettysburg Ambulance Service, Gettysburg Police Department, Gettysburg City Council, CHS River Plains, Great Western Bank, Gettysburg-In-Action (GIA,) and several members from the fundraising committee, which includes business representation from the main local restaurant (Mini Mall,) Logan Electric and homeowners who rent homes to those in the community, all had representation during the focus group. Individuals from the community who represent broad interests of the community served including medically underserved, low-income or minority populations were in attendance. Following the focus group, an electronic survey was sent to members of the groups listed above, as well as school officials, other community business leaders, and employees of the healthcare campus. Avera Gettysburg Medical Center Part V, Section B, Line 11: Avera Gettysburg conducted a community health needs assessment during FY2022. The prioritization process was done by the hospital administration and other healthcare professionals, along with community members serving on the new healthcare facility's fundraising committee, all of whom are highly engaged with the community and general community health needs. The process took into consideration the size of the problem (i.e. how many people does it impact,) urgency of the health need, the potential impact for the community, the feasibility of being able to address the concern and the value it would bring to the community.Based on the results of this assessment, Avera Gettysburg will work to address the following identified significant community health needs: *Increase community wellness, specifically through a new recreation center *Care for the elderly and aging population *Secure more mental health services INCREASE COMMUNITY WELLNESS, SPECIFICALLY THROUGH A NEW RECREATION CENTERFY2023 Update:With the planning for a new community wellness/recreation center on hold, efforts over the last year have been focused on opening our therapy gym to community and hosting a community open house with a focus on wellness. In January 2023, the therapy gym opened for after-hours access to community members. To date, we have 80 community members utilizing the space. In April 2023, we hosted an open house for community members to receive a tour of the facility, meet our two new Physician Assistants, and visit the health fair hosted in our therapy gym. The fair consisted of educational materials highlighting services offered including outreach providers, Careflight membership, sun safety and Stop the Bleed. Our registered dietician hosted a booth on 'building a better breakfast' where she showcased how to make healthy pancakes and fruit and yogurt parfaits. CARE FOR THE ELDERLY AND AGING POPULATIONFY2023 Update:In the winter of 2023, hospital nursing staff began visiting the local senior center to take blood pressures weekly with appropriate recommendations if it was not normal. It was received well. In the spring, the frequency fell off due to staff availability, although we have reengaged and are going as often as possible, most often monthly. Our 2022 year end fundraising mailer was focused on making improvements to our resident rooms in the Avera Oahe Manor. Gratefully, a resident's daughter shared her mom's story and wrote the letter encouraging our community members to donate toward this cause. We received $30,000 in donations that we have successfully used in renovating one of five planned resident rooms. The renovations will consist of fresh paint, new flooring, lights, curtains, countertop and sink, toilet, mirror and shelving around the sink. Summer 2023 started the Flex Nurse program where we hope to recruit nurses in our community back to working at the Manor, under a PRN status, or on an "as-needed" basis, paid at a higher premium. We have hired two Flex Nurses to date. SECURE MORE MENTAL HEALTH SERVICESFY2023 Update:In October 2022 we implemented the use of Avel eBH, in both our emergency department and inpatient med/surg unit. The service gives our team 24 hour access to a psychiatrist, to complete a behavioral health assessment, assist in medication management and other treatment, and transfer of patient if necessary. Based on our behavioral health visit volume in years' past, our projected volume was not expected to exceed 25 visits annually. We have received excellent feedback from our care team in having this service as a support to them, and ultimately what is right for the patient. Avera Health Foundation funds this service completely. Conversations continue with our local and surrounding area counseling services. Our local counselor does not accept insurance, so access is limited for many of our referrals on a self-pay basis. We will continue to work to see how we can partner with Avera Health Foundation on these instances. We continue to refer to two counseling services in Pierre, SD, who are accepting new patients.The following health needs were identified but will not be addressed: *Housing options - safe and affordable *Workforce concerns *Healthy eating optionsMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Avera Gettysburg Medical Center 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 Gettysburg Medical Center Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. Avera Gettysburg Medical Center Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. Avera Gettysburg Medical Center 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. Part V, Section B, Lines 7a, 7b and 10a: avera.org/about/community-health-needs-assessments/#gettysburg Part V, Section B, Line 16a, 16b, and 16c: avera.org/patients-visitors/charity-patient-assistance-programs/ Part V, Section A website address: avera.org/locations/profile/avera-missouri-river-health-center/ 2 1 - Avera Oahe Manor 700 East Manor Gettysburg SD 57442 Long term care facility 2 - Avera Oahe Villa 801 East Blaine Gettysburg SD 57442 Senior 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 expense was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Subsidized health services were calculated based on a combination of the Medicare cost report and an overall cost-to-charge ratio for certain expenses. Cash and in-kind contributions are reported based on actual expenses recorded in the general ledger. Part I, Line 7g: Provider based clinic costs are included in subsidized health services. Revenues of $786,033 and costs of $1,403,235 were included for a net community benefit of $617,202. 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 19 and 20. Part III, Line 8: Avera Gettysburg provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. Part VI, Line 2: In addition to identifying needs through the CHNA process, administration is made aware of needs of the community served through quarterly meetings of medical staff who discuss needs identified through patient interaction, communications from the hospital auxiliary and weekly Rotary meetings attended by administration. During the discharge process, staff visit with high risk patients to determine if they have support at home. If not, staff work with the patient's family members or neighbors to help meet their needs. 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 Gettysburg is a 7-bed critical access hospital. The primary service area is defined as Potter County, South Dakota, including the communities of Gettysburg, Hoven, Tolstoy and Lebanon. Over 90% of inpatient discharges were from Potter County. According to the U.S. Census Bureau Quick Facts 2021 data, the estimated population of Potter County as of July 1, 2021 is 2,475 and is predominately white at 92.8%. It is estimated that 27.8% of the population is 65 years and over. The median household income is $57,120 with a 9.4% poverty rate. Uninsured individuals under age 65 is estimated at 11.1%. Part VI, Line 5: The Hospital serves all persons in the community on a non-discriminatory basis. Avera Gettysburg operates an emergency room that is open to all persons regardless of ability to pay. Avera Gettysburg has an open medical staff with privileges available to all qualified physicians in the area. The governing body is comprised of primarily independent persons representative of the community as a whole. Avera Gettysburg participates in Medicaid, Medicare, Champus, Tricare and/or Other Government sponsored Health Care Programs. 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 1075517 0 460 0 10475 0 15250 0 1838 0 1103540 0 0 Dr Mark Hagy Board Member/Orthopedics 0 732133 0 32160 0 62989 0 15250 0 14680 0 857212 0 0 Dr Mikel Holland CMO/President/CEO (End 03/2023) 0 392025 0 460 0 5173 0 15250 0 38960 0 451868 0 0 Dr Amy Lueking - Board mbr to 03/2023)/VP of Med Affairs/CMO 0 276480 0 49551 0 1451 0 15250 0 33800 0 376532 0 0 Connie Belford Nurse Practitioner 161956 0 612 0 2927 0 8559 0 33002 0 207056 0 0 0 Daylon Wigart Nurse Practitioner 148314 0 0 0 17756 0 6310 0 33763 0 206143 0 0 0 Kristi Livermont MBA Administrator 134521 0 0 0 158 0 6735 0 11147 0 152561 0 0 0 Todd Forkel Former President/CEO 0 112827 0 0 0 1171 0 5725 0 5693 0 125416 0 0 Schedule J, Part I, Line 3: President/CEO serves Avera St. Mary's and Avera Gettysburg and was compensated by a related organization, Avera McKennan. Avera Gettysburg relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. Form 990, Item J: The organization's website is: avera.org/locations/profile/avera-missouri-river-health-center/ Form 990, Part V, Line 1a: Number reported in Box 3 of Form 1096: Avera Gettysburg does not issue Form 1099s directly. Instead, Form 1099s are issued on behalf of Avera Gettysburg by its parent, Avera St. Mary's. Form 990, Part VI, Section A, line 2 Julie Lautt, Dr. Mikel Holland, Todd Forkel and Sister Penny Bingham have a business relationship. Julie Lautt, Dr. Mark Hagy, Rena Robbennolt, and Shantel Krebs have a business relationship. Form 990, Part VI, Section A, line 6 The sole member of the organization is Avera St. Mary's, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera St. Mary's, as the sole member of Avera Gettysburg, 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 The following rights and actions of the Member shall be reserved to and exercised exclusively by the Member, except subsections 16), 17), and 18) are reserved solely to Avera Health, the sole corporate member of Avera St. Mary's: 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 Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. 16) 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. 17) 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. 18) (i) Full and exclusive power to 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 Interim President and CEO is paid by Avera McKennan, a related organization. The Director of Total Rewards was consulted and market data for the permanent CEO position was reviewed. Since the position is interim an interim stipend was added to base salary. The CFO-Avera Health is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Form 990, Part VI, Section C, line 19 The organization's governing documents and conflict of interest policy are not 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 1,942,839. Management and general expenses 22,986. Fundraising expenses 0. Total expenses 1,965,825. Medical Professional Fees: Program service expenses 146,221. Management and general expenses 0. Fundraising expenses 0. Total expenses 146,221. Repairs & Maintenance: Program service expenses 306,221. Management and general expenses 2,144. Fundraising expenses 0. Total expenses 308,365. Centralized Services: Program service expenses 0. Management and general expenses 825,703. Fundraising expenses 0. Total expenses 825,703. Form 990, Part XI, line 9: Change in Interest in Avera Health Foundation 476,917. 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 Gettysburg. Form 990, Part X, Line 20: Avera Gettysburg 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. Avery Gettysburg 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 300 Sioux Falls SD 57108 460422673 Promotion of Health SD 501(c)(3) Line 10 N/A 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera at Home 5300 S Broadband Lane Sioux Falls SD 57108 460399291 Home Services SD 501(c)(3) Line 10 Avera Health 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health Financing and Health Plan Admin SD 501(c)(4) Avera Health 0 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare Services MN 501(c)(3) Line 3 Avera Health 0 Avera Granite Falls 345 10th Ave Granite Falls MN 56241 843156881 Healthcare Services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare Services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Queen of Peace Hospital 525 North Foster 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 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 St Benedict Health Center Foundation West Glynn Drive PO Box B Parkston SD 57366 460458725 Support Health Related Services SD 501(c)(3) Line 12a, I St Benedict Health Center 0 Avera Home Medical Equipment of Floyd Valley Hospital LLC 714 Lincoln St NE Lemars IA 51031 820582350 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Lakes Regional Healthcare LLC 2301 Hwy 71 South Ste D Spirit Lake IA 51360 862949748 Medical services - home medical equipment IA N/A 0 0 Avera Home Medical Equipment of Sioux Center LLC 38 19th ST SW Sioux Center IA 51250 753203100 Medical services - home medical equipment SD N/A 0 0 Avera Home Medical Equipment of Spencer Hospital LLC 2400 S Minnesota Ave 102 Sioux Falls SD 57117 800619999 Medical services - home medical equipment SD N/A 0 0 Brookings Health System - Avera Home Medical Equipment LLC 101 22nd Ave Suite 101 Brookings SD 57006 453204123 Medical services - home medical equipment SD N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 7509 NW Tiffany Springs Parkway Ste Kansas City MO 64153 611843657 Accountable care organization MO N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 7509 NW Tiffany Springs Parkway Kansas City MO 64153 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 SD N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Pennsylvania St 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 Ave 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 1 1 1 1 1 1 1 1 Form 990, Schedule R, Part II St. Benedict Health Center Foundation dissolved as of December 31, 2022.