Avera@Home

Legal name: Avera at Home

Nonprofit profile at a glance

EIN
460399291
IRS 990 coverage
2009–2024
Official website data refreshed
Sep 2026
Forms available
Form 990 2024, Form 990-T 2024
Location
Sioux Falls, SD, US
Phone
605-322-4065
Rating
68
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Health - General and Rehabilitative N.E.C.

Official website

Reported finances

Revenue
$88,211,233
Expenses
$85,114,912
Assets
$72,801,965
Liabilities
$36,142,010

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

21 people listed

Executive titles in this filing

  • Debra Streier Board (Member/Regional President/CEO Marshall)
  • Sandra Dieleman (President/CEO)

Highest reported compensation

  • Julie Lautt (CFO Avera Health;Secretary/Treasurer): $1,294,581 total reported compensation
  • Dr Magdalene Fiddler (Board Member/Hospitalist): $718,053 total reported compensation
  • Dr Matthew Winkelbauer Board (Member/Family Med/OB(Until June)): $690,814 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

Avera's mission is to have a positive impact in the lives of persons and communities.

What it reported doing in 2024

Avera at Home provides a variety of home care services that make it possible for individuals to remain in their home rather than long-term residential or nursing home facilities. Avera at Home is a full-service, accredited home medical equipment provider offering a variety of medical and health-related items for purchase or rent. Additionally, it provides quality home health care with a full range of skilled nursing, therapy, and home health aide services.Finally, Avera at Home provides hospice care for people facing a life-limiting illness or injury. Quality, compassionate care is provided in the patient's home or within a 16-bed residential and inpatient care hospice facility in Sioux Falls, South Dakota.

Operating model

Revenue model
Other-operating. 96% of the money available for current operations came from other operating revenue.
Distribution model
Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. Few specific pay-setting methods are documented in the filing; unanswered boxes are not proof of absence and a relatively small share of voting board members are independent.

Rating breakdown

  • Financial Efficiency: 73
  • Transparency & Controls: 71
  • Accountability: 53
  • Sustainability: 45
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 81.2%; rating input score 81
  • Program expense ratio: 83.2%; rating input score 83
  • Fundraising efficiency: Limited

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
  • Pay-setting controls: 0 of 6 controls in place; rating input score 0
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Missing
    • Board or committee approval: Missing
  • Foreign activity oversight: Limited
  • Grant itemization coverage: Limited
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Yes; rating input score 100

Accountability

  • Independent voting board: 27.3%; rating input score 27; 10th percentile among comparable filings
  • Governance controls: 8 of 9 controls in place; rating input score 89
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Fail
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 3.5%; rating input score 50; 50th percentile among comparable filings
  • Total-asset coverage ratio: 0.86; rating input score 34; 34th percentile among comparable filings
  • Liabilities to assets ratio: 0.5; rating input score 36; 36th percentile among comparable filings
  • Officer compensation ratio: 1.7%; rating input score 62; 62nd percentile among comparable filings

Growth

  • Program expense growth: 11.6% per year; rating input score 100; 80th percentile among comparable filings
  • Revenue growth: 16.5% per year; rating input score 100; 90th percentile among comparable filings
  • Asset growth: 18.9% per year; rating input score 100; 92nd percentile among comparable filings

Details

  • What they do: 5 programs and campaigns described on the official site · 1 operating location identified
  • Where the money goes: 81.2% of revenue deployed · 83.2% of spending went to programs
  • Governance: 3 of 11 board members independent · 8 of 9 filing controls reported
  • Programs: 1 filed program accomplishment · $70.8M in reported program spending
  • Leadership: top reported pay $1.3M · 21 people listed · 0 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $10.2M reported
  • Consistency: 33 of 33 current checks pass
  • Schedules: 7 filed schedules · includes major donors, executive pay, and related organizations
  • Filing history: 16 filing years from 2009 to 2024
  • Contacts: How to reach this organization
  • Money network: 5 filed money-flow records
  • Related organizations: 33 filed related-organization links
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • High — Transparency & Controls: Pay-setting controls scored 0/100.
  • High — Accountability: Independent voting board scored 27/100.
  • Review — Sustainability: Operating margin scored 50/100.
  • Moderate — Sustainability: Total-asset coverage ratio scored 34/100.
  • Review — Accountability: Governance controls: CEO compensation review process not reported.
  • Moderate — Sustainability: Liabilities to assets ratio scored 36/100.