SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Avera Marshall
 
Employer identification number

41-0919153
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    579,265   579,265 0.560 %
b Medicaid (from Worksheet 3, column a) . . . . .     7,180,349 6,654,660 525,689 0.510 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     7,759,614 6,654,660 1,104,954 1.070 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     270,857 5,649 265,208 0.260 %
f Health professions education (from Worksheet 5) . . .     184,349   184,349 0.180 %
g Subsidized health services (from Worksheet 6) . . . .     8,884,017 2,994,846 5,889,171 5.690 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     53,937   53,937 0.050 %
j Total. Other Benefits . .     9,393,160 3,000,495 6,392,665 6.180 %
k Total. Add lines 7d and 7j .     17,152,774 9,655,155 7,497,619 7.250 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     121   121 0 %
2 Economic development     1,303   1,303 0 %
3 Community support     133,077   133,077 0.130 %
4 Environmental improvements     10   10 0 %
5 Leadership development and
training for community members
    73,741   73,741 0.070 %
6 Coalition building     263   263 0 %
7 Community health improvement advocacy     920   920 0 %
8 Workforce development     404   404 0 %
9 Other            
10 Total     209,839   209,839 0.200 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,209,369
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
22,265,192
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
22,294,190
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-28,998
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Avera Marshall Regional Medical Center
300 S Bruce Street
Marshall,MN56258
www.averamarshall.org
00343
X X     X   X   7 Provider Based Clinics  
Schedule H (Form 990) 2018
Page 4
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Avera Marshall
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Page 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Page 5
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Avera Marshall
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Part V, Page 8
b
See Part V, Page 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Page 6
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
Avera Marshall
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Page 7
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Avera Marshall
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Page 8
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Avera Marshall Part 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.
Avera Marshall Part V, Section B, Line 6b: Southwest Health and Human Services
Avera Marshall Part V, Section B, Line 11: The community health needs assessment was completed during the tax year and as such the hospital has not taken specific actions with respect to the current implementation strategy. The following community health areas were identified and the following actions will be taken by the hospital during future years.Mental Health * Increase the proportion of adults and children with mental health disorders who receive treatment. Improve behavioral health (BH) access and quality care. Increase appropriate use of screening and prevention services. * Increase awareness and reduce stigma around mental health issues and assist in disbursing local resource materials. Increase involvement with National Alliance on Mental Illness of Minnesota (NAMI).* Tap into depression resources * Provide employees with a depression screening tool * Provide and enhance utilization of employee assistance program (EAP) resources * Provide better adherence to medical care for those with behavioral health (BH) conditions measured by % of patients receiving BH screening and % of patients discharged with a BH referral. * Continue to operate mental health services, including inpatient and outpatient psychiatric programs. Partner with mental health providers to offer education on stress management to our patients and the community. * Further integrate mental health services into Primary Care. Monitor and improve collaborative opportunities between medical and behavioral health care. * Position Avera Marshall Behavioral Health as a Center of Excellence for the practice of Dialectical Behavior Therapy (DBT) as a champion for the Zero Suicide initiative. Obesity/Diabetes* Continue to collaborate with partner agencies to assist community members in obtaining needed nutritional information. * Explore potentialities in developing healthy eating and exercising programs to be promoted via affected communities' chambers of commerce and religious organizations. * Promote Obesity screening and counseling * Promote Healthy diet and physical activity * Provide hospital classes with Nutrition Services and Dieticians to cook healthier * Provide Weight loss Programs * Provide Wellness Coaches * Facility will provide meeting support * Continue working on strategies related to overall BMI improvement * Continue Education and screenings at health fairs and educational events* Distribute information on community resources such as free meals and food pantries * Support community support groups by providing meeting space, speakers, and educational topics Tobacco and e-cigarette use and exposure* Emphasize communication and education on the health risks associated with tobacco and e-cigarette use (vaping) and exposure. * Initiate, promote and enforce smoking/vaping free policies on healthcare facilities grounds and promote asking partnering suppliers and onsite vendors to do the same.* Continue current and expand hospital prevention classes* Facility will provide Tobacco Cessation Programs and meeting support* Employees will participate in community education to promote the prevention of smokingThe following health needs/priorities will not be directly addressed by Avera Marshall due to capability to address by other community organizations:* Cardiovascular disease* Cancer* Aging issuesMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.
Avera Marshall 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 Marshall Part 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 Marshall 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 Marshall Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Schedule H, Part V, Section B, Line 7b: https://www.avera.org/about/community-health-needs-assessments/#marshall
Schedule H, Part V, Section B, Line 10a: https://www.avera.org/about/community-health-needs-assessments/#marshall
Part V, line 16a-c The FAP, FAP Application, and Plain Language Summary are available at:https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Page 9
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address Type of Facility (describe)
1 1 - Avera Morningside Heights Care Center
300 S Bruce Street
Marshall,MN56258
nursing home
2 2 - Avera Marshall SW Ophthalmology
300 S Bruce Street
Marshall,MN56258
ophthalmology, optical
3 3 - AMG Optometry Redwood Falls
500 E Bridge Street
Redwood Falls,MN56283
optometry, ophthalmology, optical
4 4 - AveraNow
900 E Main Street
Marshall,MN56258
convenience clinic
5 5 - AMG Optometry Tracy
505 State Street
Tracy,MN56175
Optometry, ophthalmology, optical
6 6 - AMG Optometry Springfield
602 N Jackson Ave
Springfield,MN56087
Optometry, ophthalmology, optical
7 7 - Avera Medical Group Carlson
1521 Carlson Street
Marshall,MN56258
healthcare clinic
8 8 - Avera Surgery Center Marshall
1521 Carlson Street
Marshall,MN56258
surgical care
9 9 - Avera Therapy Marshall
1420 East College Drive
Marshall,MN56258
physical, speech, and occupational therapy
10
Schedule H (Form 990) 2018
Page 10
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
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 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, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded to the general ledger.
Part I, Line 7g: Provider based clinic costs are included in subsidized health services. Revenues of $1,337,127 and costs of $2,565,891 were included for a net community benefit of $1,228,764.
Part I, Ln 7 Col(f): Bad debt expense of $1,209,369 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage.
Part II, Community Building Activities: The organization provides education to community groups, has staff that serve on various comittees/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: Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year.Bad debt expense on line 2 is reported at charges as presented on the financial statements.
Part III, Line 3: 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 III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses can be found on page 11 of the attached audited financial statements.
Part III, Line 8: Avera Marshall provides services to patients under the Medicare program knowing they will 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, 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 the CHNA, the organization also assesses the needs of the community by utilizing patient surveys, meeting with other organizations to determine needs of the community, and by having the professional medical staff meet/discuss patient needs based on their daily interactions.
Part VI, Line 3: Anyone who is uninsured receives a letter with their itemized bill which describes both the uninsured program and the charity care program. Any uninsured patient is contacted by phone or letter by the collections department at which time the programs are described. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the charity care and uninsured programs.
Part VI, Line 4: Avera Marshall's service area includes Lyon County and surrounding counties in Minnesota. In 2018, the population for Lyon County was estimated to be 25,629. Approximately 15.8% of the population is age 65 or older. The average per capita income is $30,531 and approximately 12.1% of individuals are below the federal poverty level. The nearest hospital in the area is approximately 22 miles from Avera Marshall.
Part VI, Line 5: The organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. Charity care is available for those with a diminished ability to pay. In addition, Avera Marshall is the sole provider for hospital inpatient care, the only physician staffed 24/7 ER, birthing center and full service surgery center. As a result of the mission statement, 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. Avera Marshall also operates AveraNow to provide an alternative, low-cost convenience care for walk-in patients. Avera Marshall is very involved in the community. Avera Marshall's leadership team is encouraged to participate in civic and community organizations. Avera Marshall staff also volunteers on a monthly basis to Esther's Kitchen (free meals provided at a local church) and Ruby's Pantry (monthly program providing fresh and frozen foods for a small payment). Avera Marshall offers classes such as childbirth and various other support groups. Planet Heart community screenings are provided with reduced imaging fees in addition to free vein screenings. Avera Marshall provides educational experiences for school-aged children, students needing work study experience and med student internships. Avera employees volunteer through programs such as Junior Achievement. Educational classes are held at the Marshall YMCA. Physicals for sports are given to students who have no means to pay but wish to participate in athletic activities at Marshall schools. Basic supply items are donated to school nurse providers for triage care. Avera Marshall participates in community health events such as Community Connect which provides options on accessing health care resources. On an annual basis Avera Marshall provides scholarships for medical students. The Foundation, a department of Avera Marshall, focused on raising dollars for community health needs, such as assistance with mammograms through the Tough Enough to Wear Pink campaign, the baby hat and blanket fund and more. All fundraising activities go through Avera Health, a related organization. Avera Marshall also offers many opportunities for community members to volunteer. In partnership with Big Stone Therapies, Avera Marshall provides athletic trainers to many high schools throughout the Marshall region with no cost to the schools districts.
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 H (Form 990) 2018
Additional Data


Software ID:  
Software Version: