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Avera McKennan
1325 South Cliff Ave
Sioux Falls, SD 57117
EIN: 460224743
The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more
Individual Facility Details: Avera Flandreau Hospital214 North Prairie Ave
Flandreau, SD 57028
Flandreau, SD 57028
8 hospitals in organization:
(click a facility name to update Individual Facility Details panel)
(click a facility name to update Individual Facility Details panel)
| Bed count | 18 | Medicare provider number | 431310 | Member of the Council of Teaching Hospitals | NO | Children's hospital | NO |
Avera McKennanDisplay data for year:
Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
5.46%
Spending by Community Benefit Category- 2021
(as % of total functional expenses)
(as % of total functional expenses)
Community Benefit Spending Compared to Functional Expenses, 2010-2021
Additional data
Community Benefit Expenditures: 2021
All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Operating expenses $ 1,405,209,002 Total amount spent on community benefits as % of operating expenses$ 76,727,614 5.46 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 19,268,248 1.37 %Medicaid as % of operating expenses$ 25,283,957 1.80 %Costs of other means-tested government programs as % of operating expenses$ 1,014,402 0.07 %Health professions education as % of operating expenses$ 8,728,024 0.62 %Subsidized health services as % of operating expenses$ 10,862,536 0.77 %Research as % of operating expenses$ 5,900,744 0.42 %Community health improvement services and community benefit operations*
as % of operating expensesNote: these two community benefit categories are reported together on the Schedule H, part I, line 7e.$ 4,298,698 0.31 %Cash and in-kind contributions for community benefit* as % of operating expenses$ 1,371,005 0.10 %Community building*
as % of operating expenses$ 392,753 0.03 %- * = CBI denoted preventative categories
- Community building activities details:
Did tax-exempt hospital report community building activities? YES Number of activities or programs (optional) 0 Physical improvements and housing 0 Economic development 0 Community support 0 Environmental improvements 0 Leadership development and training for community members 0 Coalition building 0 Community health improvement advocacy 0 Workforce development 0 Other 0 Persons served (optional) 0 Physical improvements and housing 0 Economic development 0 Community support 0 Environmental improvements 0 Leadership development and training for community members 0 Coalition building 0 Community health improvement advocacy 0 Workforce development 0 Other 0 Community building expense
as % of operating expenses$ 392,753 0.03 %Physical improvements and housing as % of community building expenses$ 75,000 19.10 %Economic development as % of community building expenses$ 281,502 71.67 %Community support as % of community building expenses$ 7,500 1.91 %Environmental improvements as % of community building expenses$ 0 0 %Leadership development and training for community members as % of community building expenses$ 22,069 5.62 %Coalition building as % of community building expenses$ 6,682 1.70 %Community health improvement advocacy as % of community building expenses$ 0 0 %Workforce development as % of community building expenses$ 0 0 %Other as % of community building expenses$ 0 0 %Direct offsetting revenue $ 0 Physical improvements and housing $ 0 Economic development $ 0 Community support $ 0 Environmental improvements $ 0 Leadership development and training for community members $ 0 Coalition building $ 0 Community health improvement advocacy $ 0 Workforce development $ 0 Other $ 0
Other Useful Tax-exempt Hospital Information: 2021
In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.
Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
as % of operating expenses$ 36,239,541 2.58 %Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program? NO - Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.
Does the organization have a written financial assistance (charity care) policy? YES Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients? YES Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
as % of operating expenses$ 0 0 %- Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Reported to credit agency Not available Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid? NO The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines? YES In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.
Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute? NO
Community Health Needs Assessment Activities: 2021
The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.
Did the tax-exempt hospital report that they had conducted a CHNA? YES Did the CHNA define the community served by the tax-exempt hospital? YES Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital? YES Did the tax-exempt hospital make the CHNA widely available (i.e. post online)? YES Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA? YES
Supplemental Information: 2021
This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
- Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4A (Expenses $ 1260755871 including grants of $ 724460) (Revenue $ 1353905939) Avera McKennan's mission is to provide healthcare services to Sioux Falls, South Dakota residents and residents of the surrounding area. Avera McKennan is a 501(c)(3) organization affiliated with Avera Health. Avera McKennan consists of a 572-bed hospital, a 53-bed heart hospital and a 114-bed nursing home in Sioux Falls, SD. Major service lines include oncology, surgery, obstetrics, pediatrics, neonatology, emergency and trauma, critical care including EICU, radiology and diagnostic imaging, psychiatry, pulmonary, orthopedics, neurology, cardiology and gastroenterology. Transplant services include solid organ (kidney, liver, and pancreas) and bone marrow transplant.Program service statement continued on Schedule O.Avera McKennan owns or leases rural critical hospitals and a nursing home in South Dakota including a 25-bed critical access hospital and a 42-bed nursing home in Gregory, SD, a 25-bed critical access hospital in Milbank, SD, a 23-bed critical access hospital in Dell Rapids, SD, an 18-bed critical access hospital in Flandreau, SD, an 11-bed critical access hospital in Miller (Hand County), SD and an 11-bed critical access hospital in Rock Rapids, IA. Services offered by the rural critical access hospitals include radiology and imaging, colonoscopy and endoscopy, therapy and rehabilitation, 24-hour emergency care, chemotherapy, orthopedics, cardiovascular testing, surgery, dialysis and obstetrics.In addition, Avera McKennan provides clinical care, secondary and primary, through physician clinics in South Dakota, Northwest Iowa, Southwest Minnesota and Northeastern Nebraska. The physician clinics provide primary care and urgent care, and specialties such as cardiology, dermatology, endocrinology, gastroenterology, hematology, hepatology, infectious disease, internal medicine, neonatology, nephrology, neurology, ob/gyn, oncology, ophthalmology, pediatrics, orthopedics, pain management, psychiatry, pulmonology, general surgery, and vascular services. Following is a breakdown of these statistics by facility:Avera McKennan Hospital25,087 Acute patient discharges1,918 Newborn patient discharges427,544 Outpatient visits3,697 Newborn patient days1,097,966 Clinic visitsAvera Heart Hospital2,433 Acute patient discharges10,388 Outpatient visits64,512 Clinic visitsAvera Prince of Peace34,777 Long-term care resident days346 Long Term Care patient dischargesAvera Gregory Hospital (CAH)297 Acute patient discharges91 Swing bed patient discharges11,051 Outpatient visits784 Swing-bed patient days15,731 Clinic visitsAvera Rosebud Country Care Center10,067 Long-term care resident days27 Long Term Care patient dischargesAvera Milbank Hospital (CAH)285 Acute patient discharges41 Newborn patient discharges87 Swing bed patient discharges20,588 Outpatient visits59 Newborn patient days665 Swing-bed patient days28,762 Clinic visitsAvera Dell Rapids Hospital (CAH)119 Acute patient discharges50 Swing bed patient discharges9,999 Outpatient visits518 Swing-bed patient days14,098 Clinic visitsAvera Flandreau Hospital (CAH)173 Acute patient discharges16 Swing Bed patient discharges11,311 Outpatient visits166 Swing-bed patient days9,157 Clinic visitsAvera Hand County Hospital (CAH)194 Acute patient discharges48 Swing Bed patient discharges11,282 Outpatient visits343 Swing-bed patient days9,084 Clinic visitsAvera Merrill Pioneer Hospital (CAH) 113 Acute patient discharges28 Swing Bed patient discharges8,806 Outpatient visits280 Swing-bed patient days6,227 Clinic visitsAvera McKennan 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 $78,274,659.Avera McKennan 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 McKennan 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 McKennan 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.
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Facility Information
Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
Avera McKennan Part V, Section B, Line 5: Avera McKennan solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted in April 2021. Key informant individual interviews were conducted in May 2021. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve these populations through their activities.
Heart Hospital of South Dakota, LLC Part V, Section B, Line 5: Heart Hospital of South Dakota, LLC solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted in April 2021. Key informant individual interviews were conducted in May 2021. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve these populations through their activities.
Avera Gregory Healthcare Center "Part V, Section B, Line 5: This year the Avera Gregory Hospital completed our 2021 Community Health Needs Assessment. We used an outside consultation to bring together multiple community members and organizations to answer the question: ""What health needs can our facility be a partner in addressing?"" Our organization used primary evidence gathering techniques with one-on-one interviews, online surveys, and town hall events. We also met with local organizations including the lions club, rotary club, city council, county commissioners, the local EMS providers, the volunteer fire department, and various church organization that represented at risk community members. The Avera Gregory Hospital Advisory Board approved the Community Health Needs Assessment."
Avera Milbank Area Hospital Part V, Section B, Line 5: The assessment process, initiated by Milbank Area Hospital Avera, is an effort to identify significant unmet health needs in the community. Community input was solicited through surveys and personal interviews with community members with special knowledge of the needs of the community. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations.
Avera Dells Area Health Center Part V, Section B, Line 5: Community input was solicited using a variety of methods. To gather a broad range of interests and ensure accurate community input and representation, individual personalized invitations went out to various groups and individuals. In addition, medically underserved, low income, and minority population groups were also invited. In addition, there were two weeks of community surveys conducted in July 2021.
Avera Flandreau Medical Center Part V, Section B, Line 5: Community input was solicited using a variety of methods. The Avera Flandreau Hospital identified individuals, and the Avera Flandreau Hospital Advisory Board was instrumental in generating community member involvement. Personalized invitations were extended to engage individuals in the CHNA process. Involved individuals and organizations include: Food Pantry, Public Health, Senior Meals Program, the Ministerial Association, the Avera Medical Group Flandreau Medical Staff, Avera Medical Group Flandreau Clinic Manager, Avera Flandreau Hospital Administrator, and the Avera Flandreau Hospital Director of Nursing and focus groups and paper surveys from May 23, 2022 to June 13, 2022.
Avera Hand County Memorial Hospital Part V, Section B, Line 5: The CHNA process began by defining the community and collecting secondary data and resources. Once that was completed, the process continued with primary data collection including online and paper surveys. The internal CHNA committee reviewed the data collected and identified the community health needs to improve overall health of the community. The needs were then prioritized. The Avera Hand County Memorial Hospital Board of Directors approved the Community Health Needs Assessment.
Avera Merrill Pioneer Hospital Part V, Section B, Line 5: Avera Merrill Pioneer Hospital conducted a community survey to collect a broad view of the community. The survey was implemented through an online format to residents in Lyon County. The survey was promoted on Facebook, with the goal of reaching a wide demographic representative of the overall county population. Paper copies of the survey were also dispersed at the Avera Medical Group Clinics in Rock Rapids, George, and Larchwood. Key informant interviews were conducted to get a closer look at problem areas identified from a previous community health needs assessment and to connect with individuals serving vulnerable/medically underserved populations. The key informant interviews were conducted over the phone with Lyon County Public Health, Sioux Rivers Regional Disability Services Coordinator, Lyon County Ambulance Director, Rock Rapids Health Center Director of Nursing, and the Central Lyon and West Lyon High School Superintendents. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children and low-income populations.
Avera McKennan Part V, Section B, Line 6a: The CHNA was conducted with Heart Hospital of South Dakota, LLC, Sioux Falls VA Medical Center, and Sanford USD Medical Center.
Heart Hospital of South Dakota, LLC Part V, Section B, Line 6a: The CHNA was conducted with Avera McKennan, Sioux Falls VA Medical Center, and Sanford USD Medical Center.
Avera McKennan Part V, Section B, Line 6b: City of Sioux Falls Health Department
Heart Hospital of South Dakota, LLC Part V, Section B, Line 6b: City of Sioux Falls Health Department
Avera McKennan "Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. The community health priority areas identified were: Active Living, Healthy Eating, Mental Health and Substance Use, Oral Health and Preventative Care. The identified needs will be addressed through a three-year, collaborative Community Health Improvement Plan (CHIP). The CHIP is a multi-partner collaboration spearheaded by the Sioux Falls Health Department, Avera McKennan Hospital & University Health Center (including Avera Heart Hospital), Sanford USD Medical Center and the Sioux Falls VA Health Care System. Lead agencies were identified to lead the three work groups established to address the five priority areas. Avera McKennan is co-leading efforts, in partnership with Sanford Health, to address Mental Health and Substance Abuse and Preventative Care strategies. In addition, Avera McKennan and the Avera Heart Hospital will participate in efforts to support strategies to improve Active Living, Healthy Eating and Oral Health. The following actions will be taken in future years to address the identified and prioritized community health needs:PRIORITY AREA #1: ACTIVE LIVINGGOAL: Get People Moving MoreOBJECTIVE 1: Decrease percentage of adults who do not participate in any leisure time activity by 2024.STRATEGIES Create a comprehensive community directory of resources and programs and distribute it across multiple channels to ensure it is accessible to residents of all ages. Track and promote active lifestyle programming activities in the community on an ongoing basis. Implement a ""Physical Activity Screening and Tailored Prescription"" program in clinical settings. Promote use of the Sioux Falls recreation trail system for exercise and transportation. Explore the underlying drivers of the high rate of fall deaths in Minnehaha County and promote evidence-based Falls Prevention programs in the community.OBJECTIVE 2: Add complete streets elements to the Sioux Falls network of streets and sidewalks by 2024.STRATEGIES Advocate for creation of an Active Transportation Advisory Board. Conduct an evaluation of the implementation of the City of Sioux Falls Complete Streets Policy. Promote safety for biking and walking in residential areas and on the recreation trail. Utilize the City of Sioux Falls Health in All Policies Committee to identify and promote collaboration across city master plans (e.g. Bicycle Plan, Pedestrian Plan, and Sustainability and Climate Action Plan) to improve active transportation infrastructure in the built environment.PRIORITY AREA #2: HEALTHY EATING GOAL: Increase Consumption of Healthy FoodsOBJECTIVE 1: Establish two new sites where residents can access fresh produce in low-income low access census tracts by 2024.STRATEGIES Promote establishment of community gardens and/or farmer's markets in Food Access Priority census tracts. Incentivize the private and non-profit sectors to establish new grocery stores or innovative programs to increase residents' access to health foods in Food Access Priority census tracts. Establish an active local food coalition by aligning key players such as the Food Council and the urban agriculture task force. OBJECTIVE 2: Increase the number of worksites with evidence-based healthy food and beverage policies by 2024.STRATEGIES Promote healthy eating in the workplace and advocate for healthy nutrition policies at worksites. Partner with organizations to establish baseline measures through a workplace survey. Re-launch Healthy Place program for restaurants and expand to include recognition for worksites.PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE USEGOAL: Reduce Deaths Due to Intentional and Unintentional InjuriesOBJECTIVE 1: Reduce the rate of suicide in Minnehaha County by 2024.STRATEGIES Create a city-wide campaign to normalize mental health conversations and care using evidence-based methodologies (e.g. ""I go to therapy""). Promote 988 phone number (starting in July 2022) as access point for behavioral health and crisis support along with the Helpline Center mental health resource database to increase awareness of health and social service resources. Provide mental health first aid trainings in worksites, schools and organizations across the community to broaden early intervention impact. Promote Lethal Means Safety trainings in the community to reduce individuals' access to lethal means such as medications and firearms.OBJECTIVE 2: Decrease the percentage of driving deaths with alcohol involvement in Minnehaha County by 2024. STRATEGIES Media campaign against alcohol overuse and driving while under the influence. Responsible server training for bars and restaurants. School-based education/programs for teens and college campuses on alcohol abuse.OBJECTIVE 3: Decrease the drug poisoning death rate in Minnehaha County by 2024. STRATEGIES Implement community campaigns targeting opioid and other drug use, highlighting harmful substances & safe storage of medications at home. Expand youth mentoring programs. Promote drug take back events, neutralizing packets, and daily pharmacy drops. Improve access to Medication-assisted treatment (MAT) and Naloxone.PRIORITY AREA #4: ORAL HEALTHGOAL: Improve Oral Health Through The Reduction Of Dental DiseasesOBJECTIVE 1: Increase the proportion of individuals utilizing the oral health system by 2024. STRATEGIES Develop an education and awareness campaign to increase the number of individuals in priority populations who have a dental visit, including 1-2 year olds, pregnant women, Medicaid recipients, and aging populations. Develop an advocacy plan to address access to care issues including Medicaid expansion and Medicaid reimbursement. Partner with local dental clinics to host free clinic events. Promote oral health assessments and referral to a dental home at medical appointments. Assist in re-implementation of the 3rd grade survey in the MSA and other related data collection. Simplify consent process to enable provision of dental care services to more children at elementary schools. PRIORITY AREA #5: Preventive CareGOAL: Increase Utilization of Preventative CareOBJECTIVE 1: Increase the percentage of residents who have had a preventative care visit in the last year by 2024. STRATEGIES Explore a system for data-sharing among local health systems to get baseline data on number of residents who had a preventative care visit. Utilize Community Health Workers to share information about primary care, cancer screenings, immunizations, and mental health resources in the community and to help individuals get connected to a provider. Educate policy and decision makers on the resident need and economic benefits of Medicaid expansion that can help people access primary care. Utilize education and engagement resources for providers to communicate with patients about screenings (e.g. information about All Women Count, etc.). Encourage worksites and employees to access screenings through primary care providers and provide on-site immunization clinics. Increase options to access transportation at no cost to individuals without transportation to attend appointments. Develop resources for use at The Link to connect clients with preventive care services.Avera McKennan and Avera Heart Hospital are addressing, or collaborating to address, all aspects of all top needs identified in the 2022 Community Health Needs Assessment.Statement continued to Part V, Section C."
Heart Hospital of South Dakota, LLC "Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. The community health priority areas identified were: Active Living, Healthy Eating, Mental Health and Substance Use, Oral Health and Preventative Care. The identified needs will be addressed through a three-year, collaborative Community Health Improvement Plan (CHIP). The CHIP is a multi-partner collaboration spearheaded by the Sioux Falls Health Department, Avera McKennan Hospital & University Health Center (including Avera Heart Hospital), Sanford USD Medical Center and the Sioux Falls VA Health Care System. Lead agencies were identified to lead the three work groups established to address the five priority areas. Avera McKennan is co-leading efforts, in partnership with Sanford Health, to address Mental Health and Substance Abuse and Preventative Care strategies. In addition, Avera McKennan and the Avera Heart Hospital will participate in efforts to support strategies to improve Active Living, Healthy Eating and Oral Health. The following actions will be taken in future years to address the identified and prioritized community health needs:PRIORITY AREA #1: ACTIVE LIVINGGOAL: Get People Moving MoreOBJECTIVE 1: Decrease percentage of adults who do not participate in any leisure time activity by 2024.STRATEGIES Create a comprehensive community directory of resources and programs and distribute it across multiple channels to ensure it is accessible to residents of all ages. Track and promote active lifestyle programming activities in the community on an ongoing basis. Implement a ""Physical Activity Screening and Tailored Prescription"" program in clinical settings. Promote use of the Sioux Falls recreation trail system for exercise and transportation. Explore the underlying drivers of the high rate of fall deaths in Minnehaha County and promote evidence-based Falls Prevention programs in the community.OBJECTIVE 2: Add complete streets elements to the Sioux Falls network of streets and sidewalks by 2024.STRATEGIES Advocate for creation of an Active Transportation Advisory Board. Conduct an evaluation of the implementation of the City of Sioux Falls Complete Streets Policy. Promote safety for biking and walking in residential areas and on the recreation trail. Utilize the City of Sioux Falls Health in All Policies Committee to identify and promote collaboration across city master plans (e.g. Bicycle Plan, Pedestrian Plan, and Sustainability and Climate Action Plan) to improve active transportation infrastructure in the built environment.PRIORITY AREA #2: HEALTHY EATING GOAL: Increase Consumption of Healthy FoodsOBJECTIVE 1: Establish two new sites where residents can access fresh produce in low-income low access census tracts by 2024.STRATEGIES Promote establishment of community gardens and/or farmer's markets in Food Access Priority census tracts. Incentivize the private and non-profit sectors to establish new grocery stores or innovative programs to increase residents' access to health foods in Food Access Priority census tracts. Establish an active local food coalition by aligning key players such as the Food Council and the urban agriculture task force. OBJECTIVE 2: Increase the number of worksites with evidence-based healthy food and beverage policies by 2024.STRATEGIES Promote healthy eating in the workplace and advocate for healthy nutrition policies at worksites. Partner with organizations to establish baseline measures through a workplace survey. Re-launch Healthy Place program for restaurants and expand to include recognition for worksites.PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE USEGOAL: Reduce Deaths Due to Intentional and Unintentional InjuriesOBJECTIVE 1: Reduce the rate of suicide in Minnehaha County by 2024.STRATEGIES Create a city-wide campaign to normalize mental health conversations and care using evidence-based methodologies (e.g. ""I go to therapy""). Promote 988 phone number (starting in July 2022) as access point for behavioral health and crisis support along with the Helpline Center mental health resource database to increase awareness of health and social service resources. Provide mental health first aid trainings in worksites, schools and organizations across the community to broaden early intervention impact. Promote Lethal Means Safety trainings in the community to reduce individuals' access to lethal means such as medications and firearms.OBJECTIVE 2: Decrease the percentage of driving deaths with alcohol involvement in Minnehaha County by 2024. STRATEGIES Media campaign against alcohol overuse and driving while under the influence. Responsible server training for bars and restaurants. School-based education/programs for teens and college campuses on alcohol abuse.OBJECTIVE 3: Decrease the drug poisoning death rate in Minnehaha County by 2024. STRATEGIES Implement community campaigns targeting opioid and other drug use, highlighting harmful substances & safe storage of medications at home. Expand youth mentoring programs. Promote drug take back events, neutralizing packets, and daily pharmacy drops. Improve access to Medication-assisted treatment (MAT) and Naloxone.PRIORITY AREA #4: ORAL HEALTHGOAL: Improve Oral Health Through The Reduction Of Dental DiseasesOBJECTIVE 1: Increase the proportion of individuals utilizing the oral health system by 2024. STRATEGIES Develop an education and awareness campaign to increase the number of individuals in priority populations who have a dental visit, including 1-2 year olds, pregnant women, Medicaid recipients, and aging populations. Develop an advocacy plan to address access to care issues including Medicaid expansion and Medicaid reimbursement. Partner with local dental clinics to host free clinic events. Promote oral health assessments and referral to a dental home at medical appointments. Assist in re-implementation of the 3rd grade survey in the MSA and other related data collection. Simplify consent process to enable provision of dental care services to more children at elementary schools. PRIORITY AREA #5: Preventive CareGOAL: Increase Utilization of Preventative CareOBJECTIVE 1: Increase the percentage of residents who have had a preventative care visit in the last year by 2024. STRATEGIES Explore a system for data-sharing among local health systems to get baseline data on number of residents who had a preventative care visit. Utilize Community Health Workers to share information about primary care, cancer screenings, immunizations, and mental health resources in the community and to help individuals get connected to a provider. Educate policy and decision makers on the resident need and economic benefits of Medicaid expansion that can help people access primary care. Utilize education and engagement resources for providers to communicate with patients about screenings (e.g. information about All Women Count, etc.). Encourage worksites and employees to access screenings through primary care providers and provide on-site immunization clinics. Increase options to access transportation at no cost to individuals without transportation to attend appointments. Develop resources for use at The Link to connect clients with preventive care services.Avera McKennan and Avera Heart Hospital are addressing, or collaborating to address, all aspects of all top needs identified in the 2022 Community Health Needs Assessment.Statement continued to Part V, Section C."
Avera Gregory Healthcare Center Part V, Section B, Line 11: The community health needs assessment was completed during tax year 2021. Three needs were identified in the CHNA: need for new facilities in our area to administer healthcare, increase diagnostic capabilities of our imaging department to eliminate unnecessary travel, and increased need for dialysis in our community. The following actions will be taken in future years to address the identified and prioritized community health needs:Construction of new facilities: hospital, clinic, long term care center Conduct community assessment to determine needs in the new healthcare structures. Fundraising efforts in the community to raise money and awareness for the project. Complete construction of the new facility by 2024.Long travel for MRI services Data analysis on number of MRI screenings conducted in our area per month. Work with providers and Emergency medical personnel to determine which diagnostic device would be best for the area. Develop and implement construction plans for a MRI suite at our new proposed construction location.Lack of dialysis services in the area Data analysis on the medical need of dialysis in our service area vs availability of those services. Work with our nephrology team and local dialysis experts to determine the number of units required and staffing Integrate a new dialysis unit into the local construction project.Other topics that came forward through the assessment processes but were not found evident or impactful enough to focus on: COVID-19 concerns including noncompliance by community and vaccination and booster rates. Housing options that are available for new people moving to the community, safe and affordable, and assistive to the aging population. Workforce concerns in how we will continue to keep the healthcare campus, local EMS service, and home health and hospice services adequately staffed, including recruitment of a doctor of medicine (MD) and registered nurses to the community. Healthy eating options including access to fresh produce at the local grocery store, more restaurants with healthy food options, nutrition classes, and healthy snack options for staff on the healthcare campus.The community health needs assessment completed during tax year 2018 identified two needs: public awareness of hospital/clinic services and nutrition education. The following were addressed during fiscal year 2022.Public awareness of hospital/ clinic services:One identified weakness was our social media presence in our community. Our posting and engagement pattern was usually one or two wellness posts per quarter. Sometimes more frequently when we had to announce a clinic closure due to weather. With the onset of the COVID-19 pandemic our posting rate increased to almost weekly for over a year. We sent out information based on CDC recommendations, new PPE requirements for visitation in both the hospital and long term care center, and vaccine information. In addition to this we utilized other more traditional forms of media to include the local newspaper and radio advertisement. In 2021 we used all of these communication channels to update the community on the building status of the new facility as well as when we expect the project to be complete.Nutrition education: Initially in the three year CHNA period this was a huge focus for us as heart disease continues to be the number one cause of death in our service area year after year. We increased the hours of our contracted dietician and offered more counseling sessions with her for the community. We also used our coordinated care team to identify low income vulnerable patients that were most at risk for heart disease and provided one-on-one care to educate and assist with their nutritional needs. Assistance was provided to the local schools to assist teachers with nutritional education and teaching children at a young age the importance of a healthy diet combined with exercise.
Avera Milbank Area Hospital "Part V, Section B, Line 11: Milbank Area Hospital Avera conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Milbank Area Hospital Avera leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Milbank Area Hospital Avera is committed to addressing the following identified significant community health need: Addition of mental health services. Greater outreach to ethnic minority patients. Health education and health screenings.The following actions will be taken in future years to address the identified and prioritized community health needs:Addition of mental health services Focus on adding mental health professionals to provide mental health services in the community. Educate and promote the 211 suicide prevention hot line. Collaborate with local school and community to provide education to school-age children about mental health in a relatable way. Continue grief support group in the community. Mental health screenings of patients at clinic and hospital registration.Greater outreach to ethnic minority patients Develop and strengthen relationships and partnerships with organizations currently serving ethnic minority populations. Distribute information packages to local corporation that employs large number of individuals with Hispanic background. Enhance offering and activities inclusive of all local cultural groups. When recruiting for various positions in the hospital and clinic, include the need for bilingual employees. Develop a community health worker program - focus on health disparities and advance health equities within underserved populations.Health education and health screenings Expand community health education and screenings, including lung and heart screening. Continue to provide bi-monthly radio interviews to educate on services available and promote health screenings such as mammograms and colon cancer screening.Milbank Area Hospital Avera will not be directly addressing other areas of concern identified through the assessment process. While the leadership team recognizes that other concerns exist, the hospital does not have the resources to address at this time.Milbank Area Hospital Avera continued to address the community health needs identified in the community health needs assessment completed in 2018. The following includes actions taken toward the previous report.FY2022 Update: Three primary care physicians have been recruited. A hospitalist program was formed which has improved workloads amongst medical staff, improving job satisfaction and patient care. There in an ongoing relationship with the local high school to offer curriculum and encourage heath careers. Students connect with all departments in the hospital during the class. FY2022 Update: Continued partnership with National Alliance on Mental Illness (NAMI) and a local group referred to as ""Moving to Wellness"" to offer and support classes and educational materials on mindfulness, grief, depression and anxiety. Resources have been provided to educate on ending the stigma of mental illness. FY2022 Update: Successful efforts have been made to improve communication with non-English speaking patients. Access to phone translation service has been implemented throughout the hospital campus. Focus has been placed on translation of appropriate patient materials. Effort and steps are being taken to add another translator."
Avera Dells Area Health Center Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. Two needs were identified in the CHNA: Offer additional local healthcare services, and access/convenience to medical care.The following actions will be taken in future years to address the identified and prioritized community health needs:Avera Dells Area Hospital will seek to expand the list of services offered by seeking out new internal and external partnerships. The focus will be on services identified in the survey portion of the CHNA prioritization including therapy services, wound care, diabetes, specialty, and imaging procedures. The hospital is committed to investing resources to promote these services to the community once implemented. To track progress of this goal, Avera Dells Area Hospital will closely monitor usage of these services to verify the strategy is effective. Results will be shared with the leadership team at Avera Dell Rapids as well as the advisory board. Avera Dells Area Hospital will seek to expand access to care and make medical care more convenient in several ways. Many of the services offered are only offered once or twice per month. To provide patients with more convenient access to care, Avera Dells Area Hospital will focus on expanding access through additional days and times for both the current services and any additional services that are implemented as part of this CHNA. To track the progress of this goal, patient volumes will be assessed during expanded hours to ensure added value to patients. Results will be shared with the leadership team at Avera Dell Area Hospital as well as the advisory board. Avera Dells Area Hospital identified the following needs not being addressed in the 2022 Implementation Strategy: tobacco education/cessation, mental health, physical activity, outreach services, and nutrition education. Each of these needs were presented to the Avera Dells Area Medical Staff, Advisory Board, and Hospital Leadership Teams during the prioritization process, all of which felt there were other more impactful areas to focus on.Avera Dells Area Hospital continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.Improve public awareness of local health care service options, which will improve community engagement around health and wellness. Awareness can be improved and generated through the new Avera Dells Area Hospital webpage, as well as through other social media avenues and public events.FY2022 Update: Continued to use social media and online portals to promote local health care services available in the community. Participated in community events to promote local health services and educate the public on preventative health and wellness programs and opportunities. Continue to promote free dietary consultations to all community members living in the Avera Dells Area Hospital service area.FY2022 Update: Continued to use community events to promote healthy eating and education on the benefits of good nutrition on health.
Avera Flandreau Medical Center Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2022. Two needs were identified in the CHNA: access to healthcare through affordability and chemical dependency. The following actions will be taken in future years to address the identified and prioritized community health needs:Access to Healthcare through Affordability- Avera is compliant with the Health Care Price Transparency Act and provides its pricing information to the public via its website. Avera has recently begun to provide out-of-pocket cost estimates for scheduled patients who will be paying for services with their own resources (not using a third-party payer). This process provides patients an estimate of what they will be responsible for after their visit. Avera is also nearing completion of a more automated process for all patients in which they will have an estimate of out-of-pocket costs they will incur for scheduled visits to Avera Flandreau Hospital and Avera Medical Group-Flandreau. - Avera offers charity care to those eligible for the service and for those who complete the necessary paperwork. Opportunities may exist to create greater awareness and greater ease of use of this process.- Avera Flandreau Hospital is actively participating in an effort to gain approval for Medicaid expansion along with Avera Health, and other hospitals in South Dakota. The facility is working to put the proposed legislation on a ballot measure and brought before the voters of South Dakota. An estimated 43,000 South Dakotans would be eligible for this expanded health insurance. Additional coverage would improve access to care and improve health outcomes for Moody County residents. Chemical Dependency Services- In 2020 Avera built the Avera Addiction Care Center in Sioux Falls. It is a residential addiction treatment facility, which offers programming and residential life for adults 18 and older. It is hoped that the expansion of services will create greater access to chemical dependency services.- Avera Behavioral Health Urgent Care is another possible resource to address chemical dependency situations in a timely manner. - The Avera Behavioral Health Assessment Team is available to our patients 24/7; this is a free service to the public. - Moody County Cares mental health board is community based and run by county residents. Avera Flandreau employees are active on the mental health board and will look for ways to partner toward meeting our goal. - The opportunity exists to partner with Flandreau area law enforcement such as the Flandreau Police Department, Moody County Sheriff, and the Santee Sioux Tribal Police. Avera Flandreau Hospital identified the following needs not being addressed in the 2021 Implementation Strategy: mental health, outreach services, and nutrition education. Each of these needs were presented to the Avera Flandreau Medical Staff, Advisory Board, and Hospital Leadership Team during the prioritization process, all which felt there were more impactful areas to focus on and utilize resources.Avera Flandreau continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.Mental Health and Chemical DependencyFY2022 Update: Avera Flandreau continued to improve public awareness of health care service options for individuals dealing with mental health concerns or chemical dependency. In January 2022, Avera Flandreau provided space in the clinic for a community mental health counselor and routinely makes referrals to this professional. Avera Flandreau Hospital provides financial support for the Hope Squad for education on suicide prevention through the Flandreau High School. The hope-squad program is an educational-school based, peer to peer curriculum. Their goals are preventing suicide though public awareness and education, reducing the stigma, and serving as a resource to those touched by suicide. Also in January 2022, Avera Flandreau co-sponsored an event at the high school that brought in a speaker from Emily's Hope to share the personal experience of the difficulties of dealing with a family member's drug overdose and how the drug use affected the whole family. The talk was followed by a question and answer session from the students.
Avera Hand County Memorial Hospital Part V, Section B, Line 11: Avera Hand County conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Hand County leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Hand County is committed to addressing the following prioritized community health needs: Mental Health Access and Resources. Health & Weight Management and Maintenance.The following actions will be taken in future years to address the identified and prioritized community health needs:Mental Health Access and Resources Work with the 211 center to review and update resource availability for the Hand County area. Evaluate contracting a Psychologist or Psychiatrist to aid in mental health care. Evaluate expansion ideas within the current resources to assist with mental health needs of the community. Evaluate the feasibility of expanding local mental health provider services. If deemed feasible, the hospital will commit financial resources and staff time for development, implementation, and sustainability. Increasing outpatient mental health care availability may decrease emergency visits due to mental health diagnoses.Health & Weight Management and Maintenance Use the hospital and clinic's Facebook platform to offer health, fitness and lifestyle education. Work with our primary clinic and contracted dietician to increase referrals through primary care to the dietician service. Identify opportunity areas for increased referrals, collaborate with the dietician, and implement the plan. Increase patient knowledge regarding proper nutrition habits, helping improve overall health outcomes.Avera Hand County continued to address the community health needs identified in the community health needs assessment completed in 2018. The following actions were taken to address the identified needs:Disease prevention and maintenanceAvera Hand County Memorial Hospital, along with Avera Medical Group-Miller, has created a Facebook page to provide education for the public. Avera has assisted with educational information to be posted on a regular basis to keep the community informed. This tool has provided positive feedback in the past year with the pandemic. FY2022 Update: The Facebook page continued to be an excellent source to provide education to the public regarding disease prevention and health maintenance. The hospital and clinic distributed at least one healthcare conditional topic per month. In January 2022, the hospital and clinic participated in the local Farm and Home Show by offering immunization information, educational handouts on fall risk and balance impairments, and complimentary blood pressure checks. In an effort to improve access and safety to entering the wellness center, the Avera Hand County CHNA committee met with the local wellness center board to request the installation of an automatic door opener. The installation was complete in fall 2021.Access to Specialty CareThe need for more access to specialty providers and a local dialysis program were a top priority. While we have a number of specialists who do outreach here, there is a need for more. We implemented eCare access to social workers for mental health services and continued to work with Community Counseling services from Huron. The eConsult program was started to offer visits for specialty providers within the Avera system. FY2022 Update: Avera Hand County continues to utilize the eservices allowing for more access to specialty care in the community. The specialties available through eConsult platform include hepatology, gynecology, and gastroenterology. Virtual Psychiatry services are available through eEmergency/eBehavioral Health in the emergency department. This includes 24/7 access to psychiatry assessment and consult for emergency department patients.
Avera Merrill Pioneer Hospital Part V, Section B, Line 11: Avera Merrill Pioneer conducted a community health needs assessment during FY2022. After review of the primary and secondary data, the Avera Merrill Pioneer leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Merrill Pioneer is committed to addressing the following identified significant community health needs:1. Improving the mental health of the community 2. Obesity3. Improve utilization of preventative careThe following actions will be taken by the hospital in future years to address the community health priority areas.Improve access to Mental Health services in Lyon County- Screen all patients for depression or mental health care needs.- Continue to participate in the Lyon County Mental Health Coalition to discuss mental health amongst school age individuals.- Utilize the services available through the expanded Avera Behavioral Hospital.Provide services and promote a healthy lifestyle- Collaborate with local grocery store to provide healthy recipes for community members to utilize.- Provide education to promote healthy eating.- Collaborate with the City of Rock Rapids to provide additional exercise opportunities for the community.Provide preventative care services to promote the health of the community- Improve immunization compliance with patients.- Improve management of chronic health conditions.- Promote completion of preventative health screenings.Avera Merrill Pioneer decided to do an abbreviated CHNA in 2020 due to the COVID pandemic. By performing a second CHNA in 2022, Avera Merrill Pioneer was able to align with Avera McKennan's CHNA schedule. Due to the COVID pandemic, information was obtained utilizing different methods to limit the exposure of those collecting the data. The short timeframe between the two Community Health Needs Assessments made it difficult to effectively evaluate the impact the initiated interventions had on the health of the community the facility serves.The following actions were taken during FY2022 to address the needs identified, mental health, obesity and chronic health conditions, in the prior community health needs assessment:Telehealth equipment has been added to the Avera Medical Group Clinic to provide telehealth services for mental health counseling. This does not add to the number of mental health providers for Lyon County, but it does help bridge the gap in areas lacking Mental Health Providers professionals. Avera Merrill continues to screen for depression and mental health care needs for patients with each admission.Interventions were implemented to manage chronic health conditions and improve the quality of life of these individuals. Interventions implemented included promotion of physical activity, promotion and education related to healthy eating, identification of individuals with chronic health conditions to optimize their health care regimen, reviewing immunizations at clinic appointments and offering vaccines to eligible patients, and offering screening of chronic disease to improve quality of life through early treatment and management of disease process. Patients seen within the facility are assessed for diabetes and pre-diabetes. Patients diagnosed with diabetes/pre-diabetes are offered diabetic education classes with our facilities' diabetic educator and dietician. Patients are taught healthy eating, maintenance of blood glucose levels, maintenance of a healthy weight, and medication management of diabetes. Patients with chronic health conditions are referred to coordinated care upon discharge from facility to ensure that patients' care plans continue to be met post-discharge. These patients receive post discharge phone calls and follow-up appointments seven to fourteen days after discharge to ensure continued improvement in their condition.
Avera McKennan 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.
Heart Hospital of South Dakota, LLC 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 Gregory Healthcare 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 Milbank Area Hospital 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 Dells Area Health 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 Flandreau 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 Hand County Memorial Hospital 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 Merrill Pioneer Hospital 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 McKennan 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.
Heart Hospital of South Dakota, LLC 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.
Avera Gregory Healthcare 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 Milbank Area Hospital 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 Dells Area Health 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 Flandreau 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 Hand County Memorial Hospital 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 Merrill Pioneer Hospital 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 McKennan 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.
Heart Hospital of South Dakota, LLC 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 Gregory Healthcare 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 Milbank Area Hospital 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 Dells Area Health 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 Flandreau 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 Hand County Memorial Hospital 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 Merrill Pioneer Hospital 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 McKennan 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.
Heart Hospital of South Dakota, LLC 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.
Avera Gregory Healthcare 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.
Avera Milbank Area Hospital 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.
Avera Dells Area Health 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.
Avera Flandreau 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.
Avera Hand County Memorial Hospital 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.
Avera Merrill Pioneer Hospital 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, line 7a: Hospital facility's website for CHNA:avera.org/about/community-health-needs-assessments/
Part V, Section B, line 10a: Hospital facility's website for Implementation Strategy:avera.org/about/community-health-needs-assessments/
Part V, Section A website addresses: Avera McKennanavera.org/locations/mckennan/Heart Hospital of South Dakota, LLCavera.org/locations/heart-hospital/Avera Milbank Area Hospitalavera.org/locations/profile/milbank-area-health-care-campus/Avera Gregory Healthcare Centeravera.org/locations/profile/avera-gregory-hospital/Avera Dells Area Health Centeravera.org/locations/profile/avera-dells-area-hospital/Avera Flandreau Medical Centeravera.org/locations/profile/avera-flandreau-hospital/Avera Hand County Memorial Hospitalavera.org/locations/profile/avera-hand-county-memorial-hospital/Avera Merrill Pioneer Hospitalavera.org/locations/profile/avera-merrill-pioneer-hospital/
Part V, Section B, line 11 Avera McKennan: "Implementation Strategy continued for Avera McKennan and Heart Hospital of South Dakota, LLC:Avera McKennan and Heart Hospital of South Dakota, LLC continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and the following actions were taken during FY22.ACCESS TO CAREExpand patient transportation program. Review current partnerships and explore new opportunities with transportation providers.Workforce transportation pilot program. Conduct a pilot program to assist qualified staff with transportation on a case-by-case basis.Avera's transportation program slowed during Covid due to the lack of drivers in the market and the transition of in-person visits to virtual care. Overall, however, Avera's transportation program has expanded to include additional departments and users and continues to be an important community health benefit directed at reducing barriers to care. Avera's workforce transportation program has continued and is also utilized on a case-by-case basis for qualifying employees in high-needs areas. Additionally, Avera applied for and received grant funding to supplement paratransit services for patients accessing health care services located outside paratransit service boundaries. FY2022 Update: The Paratransit Grant project began service in the fall of 2021 and has expanded to include qualifying patients on an inpatient and outpatient basis. Avera continues to explore additional transportation options to address community and workforce needs.BEHAVIORAL HEALTH AND SUBSTANCE ABUSEInvestigate adding a 4th wing at Avera Behavioral HealthFY2022 Update: A new 4-story wing at Avera Behavioral Health opened in March 2022. The new wing will increase access to services for all ages and specifically include an additional child behavioral health unit, an adolescent addiction inpatient residential unit, bringing the senior unit onto the campus, adding four new adult beds, expanding the partial hospital program, and 24/7 psychiatric urgent care unit.Partner with Community-Based Triage Center. Support the development of a community-based triage center to assist residents in accessing resources for addiction treatment, behavioral health, and other needs.FY2022 Update: Opened community triage center ""The Link"" in partnership with Sanford, City of Sioux Falls, Minnehaha County and Avera. Avera BHS was chosen as the operator. Over 2,500 clients have benefitted from the services since opening on June 1, 2021.CHRONIC DISEASE PREVENTIONOne Sioux Falls Project. Address social determinants of health, seek opportunities to actively support the One Sioux Falls framework that includes accessible housing, engaging people, health and safety, and workforce development.FY2022 Update: Avera remains part of the One Sioux Falls Project and is a primary stakeholder in establishing the Community Health Needs priorities through a new CHIP (community health improvement program) process. One Sioux Falls established a guiding framework for addressing social determinants of health and improving the quality of life in the Sioux Falls area. The framework included four core elements: engaging people, workforce, safety & health, and accessible housing.FY2022 Update: Avera continues to offer the Planet Heart program in communities in their footprint. The Planet Heart program offers heart and vascular screening. The program, along with tests for cholesterol and other factors, help people know their numbers as they relate to cardiac health.Healthy Food Program. Pursue program designed to prevent and limit weight gain and improve overall physical health for qualified individuals in Avera's Coordinated Care Program.Food Education Program. Create education programming focused on selecting, storing and utilizing healthier food options. Partner with Healthy Weight Project. Pursue policy, system and environmental changes to maintain or increase the percentage of people living at a healthy body weight.Avera is committed to being our patients' partner in good health. Healthy eating and maintaining a healthy weight are important steps in good health. Avera has adopted policies to encourage healthy eating. All Avera McKennan kitchens always offer healthier meal options including, but not limited to, lean entrees, salads, sides and desserts. Food vendors must meet specific criteria to ensure the health and safety of customers and patients. Avera looks for local, fresh, and sustainable products to promote health and wellness of patients and the community. Vending machine operators are encouraged to offer healthier options. Avera has developed and promoted various healthy eating and weight loss education materials. Education materials can be found on the Avera website, in physician clinics, Avera hospitals, as well as various locations around the community. Avera hosts and participates in community events to educate and promote healthy eating and healthy weight lifestyles."
Part V, Section B, Line 16a, 16b, and 16c: www.avera.org/patients-visitors/charity-patient-assistance-programs/
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Supplemental Information
Schedule H (Form 990) Part VI
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: A combination of costing methodology was used to calculate the amounts reported in the table. A cost accounting system was used to calculate Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for our tertiary medical center. A cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate charity care at cost for all entities and Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for any operations outside of the tertiary medical center. For all other amounts, costs and revenues as reflected by the general ledger system were used.
Part I, Line 7g: Physician clinic costs for transplant services are included in subsidized health services. Revenue of $915,182 and costs of $3,163,731 were included for a net community benefit of $2,248,549. Our facility is the principal provider of bone marrow, pancreas, kidney and liver transplant services throughout our service area, with the clinics as a crucial component of successful pre- and post-transplant care.
Part II, Community Building Activities: The community building activities include monetary assistance to organizations that focus their efforts on providing neighborhood improvement projects in high needs areas, children and youth development programs, local economic development, and job creation and training programs.
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 17 and 18.
Part III, Line 8: "The Medicare revenues received (line 5), allowable costs (line 6), and the resulting loss (line 7) does not include a significant portion of the Organization's expenses. These lines require use of the Medicare cost report as prepared by the required guidelines which disallows numerous costs of hospitals, particularly if they are part of an integrated system such as Avera McKennan. In these cases, the entity must file a home office cost report which ""steps down"" overhead to non-cost report entities disproportionately to actual allowable share and essentially removes the costs from the hospital's cost report entirely. Examples of a portion of these overhead costs would be finance, business office, information technology, human resources and administration. Examples of non-cost report entities operated by Avera McKennan include clinics, mobile imaging services, long-term care facilities, and other health care related businesses. There are also costs completely disallowed by cost report rules such as bad debt expense, hospitalists care, CRNA's, and interest expense. Avera McKennan also receives a Medicare Disproportionate Share Hospital (DSH) adjustment as part of the cost report due to its significant number of low-income patients served. Part III, line 5 requires inclusion of this revenue though expenses included are much lower. Schedule H instructions also require the exclusion of $9,642,591 of Medicare losses because they are included in Schedule H, Part 1, Line 7f or 7g. Including the Medicare percentage of disallowed costs, entities which don't file a cost report but nevertheless care for Medicare patients, and the impact of the home office cost report, the Medicare shortfall is $109,984,426 as opposed to a shortfall of $25,090,311.Avera McKennan follows the Catholic Health Association guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community.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 & 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: Community needs assessment occurs at various points in the system. Through annual strategic planning sessions, community leaders are brought in to update and educate Avera McKennan board members and administrative council on the successes, challenges, and service gaps in the community. Examples include community health workers, community health program leaders, community non-profit leaders, school district officials, state health department officials, and community health organizations. Leaders also serve on boards of various community organizations which seek to address the health and well-being of community members. Local governing boards of outlying facilities, who are members of the community, discuss and help direct resources to areas of targeted needs as well.
Part VI, Line 5: Surplus funds are reinvested in facilities to improve patient care.Medical staff privileges are extended to all qualified physicians in the community. The Avera McKennan Board of Trustees is principally comprised of community members from the primary service area. Members come from a variety of backgrounds ranging from private industry and banking to healthcare.Avera McKennan is a verified Level II trauma center and was the first such Center in the State of South Dakota. Avera McKennan's Emergency Department is staffed 24 hours a day with board-certified emergency specialists and provides emergency care regardless of ability to pay. Avera McKennan had 38,730 Emergency Department visits in FY 2022. Operating both Fixed Wing and Helicopter medical air transports, Avera McKennan's flight teams cover a large geographic area providing state-of-the-art air transport services and access to critical care, with 2,627 flights in the past year.Health Care Clinic: In 1992, Avera McKennan established a Health Care Clinic to provide free care for people who are uninsured or underinsured in the community. The clinic is managed by a Registered Nurse and staffed by Registered Nurses, two midlevel providers, medical residents and volunteer health care providers. The goal of the clinic is to prevent or treat patients' medical conditions before they become catastrophic. The clinic averages 366 visits per month. The clinic provides preventative care, diagnosis and treatment of illnesses and injuries, medication assistance and assistance in obtaining specialist care for patients with complex cases. The clinic also serves to train physicians, nurses and other health care students. It provides a free evening clinic one evening per month, staffed by medical students under supervision of physicians. Avera McKennan is the only health care organization to provide free services such as this in the state of South Dakota. The clinic had 4,394 visits in 2022 and was operated at an annual cost of $1,176,955. Partnership in Live Well Sioux Falls: The City of Sioux Falls received a Community Health Transformation Grant from the South Dakota Department of Health, sparking a project to improve the health and well-being of the citizens of Sioux Falls. Guided by the City of Sioux Falls Health Department, this ongoing project is known as Live Well Sioux Falls. It involves more than 24 community partner organizations. Among these partners are Avera McKennan and the other major health care system in Sioux Falls, Sanford Health. Avera plans to work in partnership with the City of Sioux Falls and Sanford Health to address the priorities of Live Well Sioux Falls and arrive at solutions which are collaborative in nature.Avera McKennan collaborates with Live Well Sioux Falls to promote the Big Squeeze, a hypertension initiative in April to promote blood pressure screening and education, with the goal of diagnosing high blood pressure. One in three American adults have high blood pressure, but only half of them have it under control, adding to the risk of stroke, heart attack and vascular disease.Residency/Health Professions Training and Internships: In 2021, Avera McKennan had approximately 55 medical residents in training at Avera McKennan in Internal Medicine, Family Practice, Psychiatry, Geriatrics and Transitional Residency Programs offered in partnership with the University of South Dakota School of Medicine. Over 1,000 students in medicine, nursing, pharmacy, physician assistant programs, medical assisting, radiology and respiratory therapy also completed clinical rotations at Avera McKennan. In non-clinical areas, Avera McKennan offers paid and nonpaid internships in the areas of research, finance, administration, therapies, exercise science and social work. Avera McKennan is currently legally affiliated with approximately 158 institutions of higher education.Patient and Community Education: Avera McKennan is a regional leader in offering educational programs for a variety of learners, leaders and employees. Utilizing advanced technology, many of these programs are provided electronically throughout the tri-state area. Educational sessions are offered to medical staff, employees, health care professionals, students at all levels and the general public. Utilizing Avera McKennan's Education Center, a broad cross-section of classes involving diverse audiences are provided as a community service each year.1. Online resources: Avera McKennan offers vast free patient educational online resources on its public website on numerous health topics, with suggestions for lifestyle change, behavior modification and management for improved health.2. To Be Well free education events were held on topics including orthopedics, cancer, diabetes, weight loss/healthy eating, multiple sclerosis, anxiety and acupuncture. 3. Forums: The Avera Behavioral Health Center offers free Friday Forums, in which school counselors and therapists are invited to presentations on children's mental health topics such as conflict cycles, reactive attachment disorder, depression and bipolar disorder in children, and teen substance use, abuse and addiction. 4. The Avera Behavioral Health Center offers free monthly educational sessions on various topics followed by discussion for adults who have been impacted by a loved one's mental illness. Topics have included grief and loss, anxiety, and parenting strategies for managing challenging behaviors.5. Women's & Children's Services: Avera McKennan's Women's & Children's Services offers a number of parenting and community education opportunities, for free or at a minimal cost. In fiscal year 2022, 52 childbirth education classes were held with 194 attendees. A total of 16 parent and family education classes were held with 249 attendees. A total of 55 car seats were issued through the South Dakota Child Safety Seat Distribution Program. Free burn education was provided to 6,055 students during presentations in schools.6. Daycare training: Free of charge, Avera McKennan offers two in-service training sessions per month to daycare providers through EmBe, with a total of 12 scheduled annually, and additional sessions for requested topics. Support groups: Avera McKennan offers approximately 10 free support groups. They range in topic from cancer to liver disease, diabetes, bone marrow transplant, stroke and grief and loss. The organization provides free meeting space as well as speakers and leaders. Information and Assistance: Avera McKennan operates a 24-hour Medical Call Center, through which patients have access to nurse triage at no cost to the patient. Patients can call a toll-free number and talk personally with a Registered Nurse to ask health questions or receive general health information. Avera McKennan's web site also provides an extensive health library that consumers can access free of charge.Interpreter service: Avera McKennan employs two full-time, two part-time and one PRN Spanish interpreter in-house, and also employs two Community Outreach Consultants that can serve as interpreters for Arabic, Amharic, Oromo, Russian and Kunama. Their services are offered to patients free of charge. In addition, in cooperation with external agencies, Avera McKennan is able to handle 210 different languages and dialects through phone, video remote interpreting and other means. Interpretation services are available for patients when they are at Avera McKennan in person, or when they call by phone. All the above services are provided at no cost to the patient.Transport to Transplant: Avera McKennan developed the Transport to Transplant project, which removes transportation barriers for patients from rural areas which may prevent them from completing the evaluation and testing needed for kidney and/or pancreas transplant. A van funded through a grant from the Avera McKennan Foundation is used to transport patients who demonstrate a financial need. Patients are brought to the Avera Transplant Institute for a condensed multi-day evaluation with all testing and visits completed in less than one week. Ultimately, the project results in improved morbidity and mortality, as kidney transplant doubles patient survival as compared to remaining on dialysis.Continued below.
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.
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 McKennan's service area is a largely rural population. Services are provided through a health care network of clinics, critical access hospitals and tertiary facilities covering communities in four states. The main tertiary facility is in a population center of over 196,500 served by another non-profit hospital of similar size, Veterans Administration Hospital, a hospital dedicated to diagnosis and treatment of heart disease, and a hospital for children with special health care needs. Outside of this population center, most of the communities served have less than 4,000 residents. The primary service area includes four counties covering approximately 2,600 square miles and contains seven federally designated medically underserved communities. Per the 2021 U.S. Census Bureau QuickFacts data, an average of 8.075% of residents in the primary service area are at or below the poverty level. Our secondary service area covers an additional 17 counties in South Dakota, Iowa, and Minnesota.
Part VI, Line 5, continued: Avera Family Wellness: This program is designed to support families and children in need of early intervention mental health services. The families have direct access to mental health services when needed. This program combines positive activities like mental health therapy (our therapists are specifically trained in dealing with high need families, a variety of play therapies and addressing issues of childhood trauma), psychiatry, family and school coordination and classroom enrichment services. Referrals come from the early childhood program, as well as our four partner elementary schools. The goal is to lessen the number of adverse childhood experiences to improve the chances for children living in poverty to be successful in school and in life. Families with the most difficult situations are being referred by the school district. We have plans to increase our staff to grow this program as we will see now more than ever, there is a need for these services due to the impact of COVID-19 and other stressors in our community, schools and families.The Walsh Family Village: This hospitality house complex adjacent to the Avera McKennan campus provides a home away from home for patients and their families who come for care at Avera McKennan from outside of Sioux Falls. The project was funded by donations and is operated by Avera McKennan. Eleven guest rooms are available. Avera McKennan also donates use of the building in the complex for a Ronald McDonald House for families of pediatric patients. If they can afford it, guests are charged a low fee per night. Guests are not turned away due to inability to pay the fee. Employees regularly donate non-perishable food items to stock a food pantry for guests. In fiscal year 2022, the Walsh Family Village served 430 guests, staying in 1,959 nightly rooms, a 77.76% occupancy. Avera McKennan provides a subsidy of approximately $128,336 per year to operate the hospitality complex. Prevention and support of substance use disorder: Avera McKennan is a partner with Face it TOGETHER, Inc., a nonprofit organization which serves as the local face and voice of recovery from addiction through its recovery support services, advocacy and awareness programs. Avera has been a partner with Face it TOGETHER since its inception, and in a recent awareness campaign.Community Connections: Avera McKennan reaches out to people and communities throughout eastern South Dakota, southwestern Minnesota and northwest Iowa through Home Town Connections. Providing a critical feedback link to local referring doctors, this program completes the communications link necessary to keep local health care providers current on the treatment of their patients at Avera McKennan.Support of the arts and cultural life: Avera McKennan hosts Sioux Falls' only indoor SculptureWalk. Artists donate sculptures for one year, which are placed at locations throughout Avera McKennan's campus, in buildings connected by skywalks. Brochures contain a map, and visitors who follow the route suggested walk approximately 1 mile, making this a healthy as well as a cultural journey.Community Benefits: Avera McKennan provides additional community benefits including: support of youth programs; homeless programs; community arts programming; health prevention; awareness and education about cancer, heart disease and other conditions; and support of the Sioux Empire United Way and other services in the region. All the programs did continue at least virtually during the pandemic. All our partners were able to be nimble and deliver services in new and creative ways, always keeping safety at top of mind during the pandemic.
