Avera Health
Nonprofit profile at a glance
- EIN
- 460422673
- IRS 990 coverage
- 2009–2024
- Forms available
- Form 990 2024, Form 990-T 2024
- Location
- Sioux Falls, SD, USA
- Phone
- 6053227300
- Rating
- 78
- Verdict
- SUPPORTED
- Rating confidence
- Moderate
- Sector
- Single Organization Support
Reported finances
- Revenue
- $359,131,383
- Expenses
- $362,404,570
- Assets
- $2,578,930,497
- Liabilities
- $2,188,023,598
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
30 people listed
Executive titles in this filing
- James Dover (President/CEO)
- Shantel Krebs (President/CEO, St. Mary's)
- Doug EkerenRetired May 2025 (President/CEO, Sacred Heart)
- Debbie Streier (President/CEO, Marshall)
- Dr Ronald Place (President/CEO, McKennan)
- Dr Hillary Rockwell (President/CEO, Queen of Peace)
Highest reported compensation
- James Dover (President/CEO): $2,504,735 total reported compensation
- David Flicek (Chief Operating Officer, Vice Pres): $1,497,202 total reported compensation
- Julie Lautt (CFO, Treasurer): $1,294,581 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 Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.
What it reported doing in 2024
Avera Health is a nonprofit corporation sponsored by Caring for Life Catholic Health Ministries under the guidance of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota and the Benedictine Sisters of the Convent of the Sacred Heart. Avera Health acts as the leader of the Avera Health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. These organizations provide services principally in eastern South Dakota and surrounding states. Avera Health provides management consulting, fund raising and other administrative services to the hospitals, long-term health care facilities, clinics, services and programs that are sponsored or otherwise affiliated with the Sisters.
Operating model
- Revenue model
- Earned-program. 91% of the money available for current operations came from fees and other program revenue.
- Distribution model
- Direct operator. The filing allocates 92% 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.
- Includes noncash contributions: Reported contributions include donated property or goods.
The verdict
SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. The filing reports few safeguards for money sent abroad and the filing does not identify recipients for some grant dollars.
Rating breakdown
- Financial Efficiency: 87
- Transparency & Controls: 63
- Accountability: 84
- Sustainability: 41
- Growth: 100
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 95.1%; rating input score 95
- Program expense ratio: 90%; rating input score 90
- Fundraising efficiency: $8.06 raised per $1 spent on fundraising; rating input score 36; 36th percentile among comparable filings
Transparency & Controls
- Consistency checks: 94.4%; rating input score 94; 31st percentile among comparable filings
- Pay-setting controls: 4 of 6 controls in place; rating input score 67
- Compensation committee: Pass
- Independent consultant: Pass
- Other Form 990s reviewed: Missing
- Written employment contract: Missing
- Compensation survey or study: Pass
- Board or committee approval: Pass
- Foreign activity oversight: Scored; rating input score 0
- Grant itemization coverage: 25.1%; rating input score 25; 7th percentile among comparable filings
- Major donor itemization: Yes; rating input score 100
- Related-party transparency: Yes; rating input score 100
Accountability
- Independent voting board: 73.3%; rating input score 73; 23rd percentile among comparable filings
- Governance controls: 9 of 9 controls in place; rating input score 100
- Conflict-of-interest policy: Pass
- Whistleblower policy: Pass
- Document-retention policy: Pass
- CEO compensation review process: Pass
- 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: -0.9%; rating input score 23; 23rd percentile among comparable filings
- Total-asset coverage ratio: 7.12; rating input score 89; 89th percentile among comparable filings
- Liabilities to assets ratio: 0.85; rating input score 15; 15th percentile among comparable filings
- Officer compensation ratio: 4.3%; rating input score 22; 22nd percentile among comparable filings
Growth
- Program expense growth: 7.7% per year; rating input score 100; 62nd percentile among comparable filings
- Revenue growth: 9.7% per year; rating input score 100; 76th percentile among comparable filings
- Asset growth: 6.9% per year; rating input score 100; 51st percentile among comparable filings
Details
- Where the money goes: 95.1% of revenue deployed · 90% of spending went to programs
- Governance: 11 of 15 board members independent · 9 of 9 filing controls reported
- Programs: 1 filed program accomplishment · $326.1M in reported program spending
- Leadership: top reported pay $2.5M · 30 people listed · 4 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $64.5M reported
- Consistency: 40 of 41 current checks pass · 1 finding to review
- Schedules: 13 filed schedules · includes major donors, foreign activity, grants, executive pay, and related organizations
- Filing history: 16 filing years from 2009 to 2024
- Contacts: How to reach this organization
- Money network: 125 filed money-flow records
- Related organizations: 141 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.
Grant-readiness screening is separate from the live rating, not a measure of program quality. Review the source records before making a grant decision.
- High — Transparency & Controls: Foreign activity oversight scored 0/100.
- High — Transparency & Controls: Grant itemization coverage scored 25/100.
- Moderate — Financial Efficiency: Fundraising efficiency scored 36/100.
- High — Sustainability: Operating margin scored 23/100.
- High — Sustainability: Liabilities to assets ratio scored 15/100.
- High — Sustainability: Officer compensation ratio scored 22/100.
- Review — Transparency & Controls: Domestic grant itemization did not reconcile in the filed values.
- High — Grant Readiness: Federal audit findings: this organization reported findings in its latest federal Single Audit.