2025-04-10T12:11:52-05:00 2024-11-30 450250958 Eide Bailly LLP 345 N Reid Pl Ste 400 Sioux Falls SD 571037034 990 2024-07-01 421317452 Holy Family Hospital Foundation AVER 7123622631 826 N 8th Street Estherville IA 51334 Michelle Majerus President/CEO Avera Holy Family 7123622631 2025-04-09 1 1 Laurie Hanson CPA P00851848 6053391999 2025-04-09 2024 2025-03-06 01:10:19Z X Michelle Majerus 826 N 8th Street Estherville IA 51334 104798 0 0928 X www.avera-holyfamily.org X 1988 IA To support and raise funds for Avera Holy Family. X 9 8 0 8 0 0 147915 8746 0 0 64480 96052 0 0 212395 104798 23050 25994 0 0 0 0 0 0 0 38319 16691 61369 42685 151026 62113 3136114 0 0 0 3136114 0 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 1 25994 25994 The Foundation continued to support Avera Holy Family Hospital through November 2024. The Foundation provided funds for hospital programming, community support events, employee education, and employee assistance. The Foundation was dissolved, and all assets were transferred to Avera Holy Family Hospital on November 30, 2024. 25994 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 0 0 0 0 0 X Michelle Majerus 7123626160 826 N 8th Street Estherville IA 51334 X Deb Herzberg -Left 102024 President/CEO Avera Holy Family 1.00 40.00 X 0 0 0 Michelle Majerus -Joined 92024 President/CEO Avera Holy Family 1.00 40.00 X 0 0 0 Phyllis Martens Chair 1.00 0.00 X X 0 0 0 Cindy White Vice Chair 1.00 0.00 X X 0 0 0 Brad Held Director/Paramedic 1.00 40.00 X 0 0 0 Robyn Swisher Director 1.00 0.00 X 0 0 0 Mike Cornwall Director 1.00 1.00 X 0 0 0 Shannon Schiltz Director 1.00 0.00 X 0 0 0 Katie Harris Director 1.00 0.00 X 0 0 0 Makenna Crookshank Director 1.00 0.00 X 0 0 0 Mike Wycoff Director 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 8746 8746 3143 3143 92909 0 92909 92909 92909 104798 0 0 96052 21494 21494 4500 4500 6538 6538 416 416 9737 9737 42685 25994 16691 0 0 0 0 0 0 0 0 0 0 0 97747 0 3038367 0 0 0 0 3136114 0 0 0 X 3136114 0 3136114 0 3136114 0 X 62113 -3198227 X 0 0 0 X 140030 205318 118224 147915 8746 620233 140030 205318 118224 147915 8746 620233 378620 241613 7480 6200 6966 3143 23789 2854 2854 646876 0.37350 0.48560 X Form 990, Schedule A, Part II: The 2024 column represents the short year 7/1/2024 through 11/30/2024, the date of dissolution. 2245019 0 68090 2308216 4893 2161172 52272 42180 10605 2245019 2097815 21024 61082 8810 9939 2161172 1873717 122865 114285 3705 9347 2097815 1758595 124047 8925 1873717 0.00000 0.00000 0.00000 0 1 1 0 Part V, Line 4: The balance of the Organization's endowments were transferred to the sole member, Avera Holy Family Hospital. 1 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 501(c)(3) 12518 0 Donation Emmet County Public Health 508 S 1st St Estherville IA 51334 426004648 Governmental 6500 0 Community Support 2 0 Part I, Line 2: Organization provides grants to a related tax-exempt organization in furtherance of its exempt purpose. No further monitoring was considered necessary. The organization provides contributions to other organizations which are tax-exempt under IRC Section 501(c)(3) and governmental divisions that benefit the community and region through programs and activities. Cash and investments 2024-11-30 3198227 Book value 420680370 Avera Holy Family 826 North 8th Street Estherville IA 51334 501(c)(3) 0 0 0 0 1 1 1 1 0 Schedule N, Part I, Line 2a: Mike Cornwall, Director, is a director for Avera Holy Family Hospital. His director role for the Hospital is not a result of the dissolution of the Foundation. Form 990, Part III, line 3 The organization ceased conducting activites and dissolved, transferring all assets to the sole member, Avera Holy Family Hospital. Form 990, Part VI, Section A, line 6 The sole member of the organization is Avera Holy Family, a nonprofit corporation organized and existing under the laws of the state of Iowa and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. Form 990, Part VI, Section A, line 7a Avera Holy Family, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors, sanction vacancies and determine the number of Directors for this Corporation. Form 990, Part VI, Section A, line 7b Avera Holy Family has the following rights as the Member. 1) Define the purpose, philosophy and mission of this Corporation. 2) Receive and approve budgets of this Corporation. 3) Review and approve audited financial reports of this Corporation. 4) Dissolve, merge or consolidate this Corporation. 5) Approve the selection and retention of the independent auditing firm. 6) Approve any action which would change the character of this Corporation. 7) Initiate and/or approve all amendments to the Articles of Incorporation and Bylaws of this Corporation. 8) Appoint and remove, with or without cause, the Directors, sanction vacancies and determine the number of Directors of this Corporation. Form 990, Part VI, Section A, line 8b There are no committees with 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 and officers. 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 Deb Herzberg, President/CEO, is compensated by Avera McKennan, a related exempt organization. Avera McKennan has a process in place for determining compensation. Michelle Majerus, President/CEO, is compensated by Avera Holy Family, a related exempt organization. Avera Holy Family has a process in place for determining compensation. Deb Herzberg left the organization in October 2024, and Michelle Majerus joined the organization in September 2024. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available upon request. Form 990, Part VI, Section A, Line 1b: Brad Held is compensated by a related organization and is therefore not considered an independent voting member. Form 990, Part VII: The timeframe of this short year Form 990 does not include a calendar yearend. As such, no compensation was reported on Part VII for individuals who were compensated by related organizations. Form 990, Part XI, line 9: Transfer to Avera Holy Family -3,198,227. Avera St Anthony's Hospital 200 N 2nd Street ONeill NE 68763 470463911 Healthcare Services NE 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 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 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare Services SD 501(c)(3) Line 3 Avera Health 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 Queen of Peace Hospital 525 North Foster Street Mitchell SD 57301 460224604 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera at Home 5300 South Broadband Lane Sioux Falls SD 57108 460399291 Home Services SD 501(c)(3) Line 10 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 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare Services SD 501(c)(3) Line 3 Avera Health 0 Avera Marshall 300 S Bruce St Marshall MN 56258 410919153 Healthcare Services MN 501(c)(3) Line 3 Avera Health 0 Avera 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 Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare Services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health Financing and Health Plan Administration SD 501(c)(4) 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 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 Sioux Center LLC 38 19th ST SW Sioux Center IA 51250 753203100 Medical Services - Home Medical Equipment SD N/A 0 0 Surgical Associates Endoscopy Clinic LLC 310 S Pennsylvania Aberdeen SD 57401 460461429 Surgical Associates SD N/A 0 0 Avera Home Medical Equipment of Spencer Hospital LLC 2400 S Minnesota Ave Sioux Falls SD 57117 800619999 Medical Services - Home Medical Equipment SD 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 Brookings Health System - Avera HME LLC 101 22nd Ave Suite 101 Brookings SD 57006 453204123 Healthcare Services SD N/A 0 0 Caravan Health ACO 41 LLC dba Prairie View Care Organization 4055 Valley View Ln Ste 700 Dallas TX 75244 821447782 Accountable Care Organization MO N/A 0 0 Caravan Health ACO 15 LLC dba Prairie Vista Care Organization 4055 Valley View Ln Ste 700 Dallas TX 75244 611843657 Accountable Care Organization MO 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 Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection Agency 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 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Rental Real Estate SD N/A C 0 Alucent Biomedical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 South Dakota State Medical Holding Company Inc 5300 South Broadband Lane Sioux Falls SD 57108 460401087 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 Alucent Australia Pty Ltd Level 10 30 Collings Street Melbourne VIC 3000 AS Biotech Research AS N/A 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 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0