Man and woman holding smiling small female child.

Avera Annual Report 2026

Avera looks back at 2026 with gratitude for the many opportunities we’ve had to live out our Gospel values of Compassion, Hospitality and Stewardship.

Guided by Our Mission

Avera Health is distinguished by our faith-based health ministry and the quality of our 23,000 physicians and employees. With the compassion for which Avera is known, we deliver quality care through medical expertise and state-of-the-art technology. Through integration of services and innovative access points, we’re changing how health care is delivered.

Founded in 2000, Avera is a regional health system comprised of 315 locations in 100 communities in five states across the Upper Midwest. Avera serves a population of 1 million throughout a geographical footprint of 72,000 square miles.

Avera excels at rural health care delivery, serving a largely rural geography. Community hospitals, clinics, long-term care centers and home care agencies deliver quality care close to home. When needed, patients have access to specialty care and services available through the strength of our system.

Avera is the health ministry of the Benedictine Sisters of Yankton, SD, and the Presentation Sisters of Aberdeen, SD. As a health ministry rooted in the Gospel, Avera’s mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

Benedictine and Presentation Sisters.

2025 Avera Health Board of Directors

Avera by the Numbers

  • 315sites of care
  • 100+communities
  • 5states
  • 72,000square mile footprint
  • 23,000employees
  • 2,200volunteers

A Message From Our Chief Executive Officer

Avera aircraft at airport in front of sunset.

Welcome to Avera’s 2026 Annual Report. Thank you for your interest in our health ministry.

Our report this year emphasizes partnership. The Avera mission, now 26 years old, is remarkable as a mission that can be shared. This is reflected in many ways, including Our Vision statement: Working with its partners, Avera shall provide a quality, cost-effective health ministry which reflects Gospel values. We shall improve the health care of the people we serve through a regionally integrated network of persons and institutions.

It’s exciting to consider the many opportunities we had over the past year to form new partnerships and strengthen existing ones. We’re working together to broaden Avera’s mission and enhance access to essential health care services and programs that make a positive impact in the lives and health of persons and communities.

2026 was also the year for a transformational project – the implementation of Avera MyChart through partnership with Epic. Epic represents one of the biggest technology investments ever for Avera, giving us a better connection to our patients and improving coordination of care.

We also continue to implement the initiatives of our three-year strategic plan known as Illuminate. Virtually every highlight of this year’s annual report contributes to the five pillars of our strategic plan.

Keep reading to learn how Avera is committed to our communities, providing benefits in urban and rural locations alike. You’ll also learn about how we develop our people and invest in better health care for everyone.

We appreciate the collaboration and partnership of many as we serve people and meet the needs that are before us, now and in the future.

Jim Dover

Sincerely,

James F. Dover, FACHE
President and Chief Executive Officer
Avera Health

A Message From Our Chief Development Officer

New mother sitting in chair, holding baby while talking with a female nurse.

Fiscal year 2026 brought much to be grateful for, and it happened because you made it possible.

Your gifts come in every form generosity takes. Some of you gave in memory or honor of someone you love, while others gave every year for five years or more, 3,478 of you in total. More than 22,000 gifts were $100 or less, proof that every gift matters. Thirty-nine of you made plans through your estate, choosing to care for patients you will never meet.

When B. Thomas Golisano made the largest single gift in Avera's history, thousands of you joined with gifts of your own, building a legacy of healing more than 130 years in the making. In the coming year, the doors will open to the Avera Women's and Children's Center, home of the Avera Golisano Children's Hospital, where more children will continue to receive the advanced care they need. Together, you will help make this historic moment possible.

In Yankton, that growth already arrived. Families used to drive hours away for cancer treatment. Because of you, they now enter through the doors of the new Avera Cancer Institute, home of the Ness Family Center. Alongside Larry and Diane Ness and First Dakota National Bank, you helped make this dream a reality.

Behind every one of these gifts is your commitment to your neighbor, friend and family. Multiply that quiet devotion by thousands across the region, each with your own reason for giving. These pages share what is possible when people come together to care for one another.

This story belongs to you as much as it does to Avera. Learn more about the Avera Foundation and read our 2026 Gratitude Report.

Yours,

Dzenan Berberovic, Chief Philanthropy Officer

Dzenan Berberovic

Chief Development Officer & Foundation President
Avera Health

Benefiting Our Communities

Community benefit extends the historic mission of nonprofit hospitals to meet the changing needs of their communities, with a focus on people who are vulnerable or disenfranchised.

Examples of Community Benefit Provided by Avera

Partnership Spotlight: Avera Wellness Pantry

Partnership Spotlight: Avera Behavioral Health

Partnership Spotlight: Avera Careflight

Charity Care and Financial Assistance

As part of our health ministry and mission, Avera cares for all patients regardless of ability to pay. With the support of patient advocates, people who are experiencing financial hardship can apply for assistance, and depending on their situation may receive medically necessary care with no obligations or discounted obligation.

For people who are uninsured, Avera offers a free downtown clinic in Sioux Falls, which sees around 7,000 visits per year.

Avera Careflight Marks 40 Years

No matter where patients experience critical injuries or illness throughout the Avera region, they deserve the same access to critical care. That’s why Avera Careflight teams based in Sioux Falls, Aberdeen and Pierre, SD, stand ready to transport patients to the level of care they need, as quickly as possible.

Careflight rotor-wing and fixed-wing aircraft are designed as airborne ICUs, staffed by professionals highly trained in critical care. Careflight makes approximately 3,000 transports per year and since inception has transported 51,000 patients.

Rooted in Schools

Avera is a proud partner with Rooted in Schools. This three-year pilot provides on-site mental health therapists at five public schools in Sioux Falls, allowing students to receive one-on-one counseling with less interruption to their school day. The program is administered by Avera Behavioral Health, in partnership with the Sioux Falls School District. It’s generously funded by the Seed for Success Foundation.

Early data shows improved attendance and a decrease in disruptive behaviors. Therapists help students build resilience for success both academically and socially, with early intervention to prevent crises.

Wellness Pantries

To address food insecurity and its impact on health, Avera has established eight clinic-based wellness pantries for food distribution, with plans to expand to additional rural communities.

Avera’s wellness pantries are funded in part by a federal Healthy Start grant through the Health Resources and Services Administration (HRSA), and operated in collaboration with Feeding South Dakota, Avera Research Institute and Avera’s Community Partnership program. They have distributed more than 2,000 bags of food, primarily supporting women, children and their families.

Other Community Benefits

  • Community health services and screenings
  • Health professions education
  • Research
  • Financial and in-kind contributions
  • Community-building activities
  • Assistance for travel, prescriptions and housing for those who need support outside of their local facilities

Learn More About How Avera Benefits Communities

Community Health Needs Assessment

In keeping with the mission of Avera and as part of the Patient Protection and Affordable Care Act of 2010, tax-exempt hospitals are required to conduct community health needs assessments (CHNA) every three years. These outline a community’s current health status, needs and priorities that tax-exempt hospitals plan and act upon to improve community health outcomes.

This is a systematic, collaborative process of collecting and analyzing data to identify a community's key health issues, needs and resources. It leads to prioritized goals and action plans for the communities we serve.

Top health needs identified across the Avera system include:

  • Behavioral health/substance abuse
  • Healthy lifestyle
  • Prevention and screening
  • Access to care

Read CHNA reports from Avera hospitals

Community Partnerships

Doctors and care teams can give the best care while people are within Avera facilities, but if they return to environments where they don’t have access to nutritious food, safe housing, transportation or education, we are only solving one piece of the puzzle. That’s why Avera partners with nonprofit organizations that help us fulfill the Avera mission to have a positive impact in the lives of persons and communities.

Avera’s community partnerships program directs donations toward organizations that serve residents in areas that include food, housing, transportation, education, mental health and quality of life. Avera partners with 250+ organizations.

Examples include:

  • Boys & Girls Clubs in Aberdeen, Yankton, Pierre, Flandreau and Sioux Falls, SD. Avera supports general programming to provide a safe place for youth with healthy meals and snacks to address food insecurity.
  • United Community Action in Marshall, MN, connecting people to the services they need such as transportation, affordable housing, emergency shelter, child care, food assistance and more. Avera funds support the purchase of food items for Marshall Kitchen Table Food Shelf.
  • Abbott House Youth Services in Mitchell and Sioux Falls, SD, which provides intensive foster care, residential treatment for trauma-impacted youth, and independent living, helping youth look forward to successful futures. Programming recently expanded to Rapid City.
  • South Dakota Discovery Center Health Career Exploration Pathway in Pierre, SD. Avera supports Discovery Days, Scrubs Camps and CNA training camps.
  • Bread Break in the Sioux Falls, SD, area. Bread Break redirects surplus food to low-income individuals and families, recovering 400,000 pounds of food in the past year. Edible food that would otherwise be wasted is transformed into a vital resource that promotes food security, dignity and economic stability.

By the Numbers

$23,594,000
Charity care/financial assistance at cost

$54,037,000
Unpaid costs of government programs

$90,741,000
Additional community benefits

$168,372,000
Total

Helmsley Center at Avera St. Mary's in Pierre, SD.

Investment in Local Communities

Avera strives to be an essential presence in each community we serve. Certainly, this means being seen as indispensable to the health and well-being of residents.

It also means serving the community economically, as a top employer and driver of economic activity, and contributing to a high quality of life that is attractive to people looking for a community in which to live, work, raise their families, or retire. For our 38 hospitals and 200 clinics in more than 100 communities, it's more than being a place that treats illness. It's about being a trusted, vital institution that people rely on every day.

Together, agriculture, health care and manufacturing make up almost 30% of South Dakota’s gross domestic product (GDP). Health care has quietly maintained a substantial part of the state’s economy, with a share that has increased from around 8% to nearly 10% over the past 25 years. (Source: Dakota Institute)

Avera's Commitment to Rural Health Care

Avera’s integrated health system is designed for the delivery of rural health care, with locations in more than 100 communities. By addressing and overcoming rural health disparities, we build better access to quality health services for all patients. Learn About Rural Health Care

Sustainability Focus

Promoting sustainability as an expression of Catholic stewardship remains an important part of Avera’s mission and our responsibility to care for our common home. Avera’s system-wide Sustainability Council brings together representatives from multiple departments and backgrounds to identify opportunities, set priorities and strengthen education and awareness around environmental stewardship across the health ministry.

This cross-departmental collaboration is building a more coordinated and mission-driven approach to sustainability throughout Avera’s ministries. Current system initiatives include:

  • Strengthening recycling efforts
  • Working toward the elimination of Styrofoam across all facilities
  • Reducing food waste by measuring waste in food preparation and refining methods over time
  • Membership in Practice Greenhealth (an organization dedicated to sustainable health care)
  • Hiring of a full-time sustainability coordinator to guide Avera through a journey of improved sustainability
  • Green Teams at local hospitals, clinics, and other facilities throughout the system. As a health care organization, we consider patient care paramount.

Our intention is to foster a lasting cultural shift that embeds this work into daily practice, ensuring that we continue to deliver care of the highest quality, while also working to improve our stewardship of the Earth.

Learn about these initiatives

Stories About Our Community Impact

Developing Our People

Four smiling health care workers talking.

Health care is a people-centered industry. For Avera, people are our most important resource.

Competent, skilled and well-trained staff who demonstrate care and compassion are vital in the delivery of quality health care. Certain professions are highly needed, including nurses, certified nursing assistants, medical lab techs and scientists, respiratory therapists, surgical techs and imaging professionals.

Learn about sponsorships and scholarships at Avera

Workforce Development Programs

Avera begins developing workforce at the high school level and earlier, helping students to see that opportunities in health care are wide open. Collaboration with educational institutions and other partners helps to further Avera’s workforce development efforts.

Frontier And Rural Medicine Program

Avera participates in Frontier And Rural Medicine (FARM), a rural track for medical students at the University of South Dakota School of Medicine. This is a unique opportunity for a select group of third-year students to complete 11 months of their clinical training in rural communities.

Avera locations in several communities are training sites, including Chamberlain, Milbank, Parkston and Pierre, SD.

“Training in rural communities offers the opportunity to experience increased hands-on education and provides a unique view of the rewards and challenges of practicing in a rural setting,” said Jason Wickersham, MD, family practitioner in Parkston and associate dean of the program.

Avera Nursing Sponsorships

The Avera Nursing Advantage program aims to provide an affordable pathway into nursing for more people in our region. Selected junior and senior nursing students at Mount Marty University in Yankton, SD, receive a generous sponsorship and the ability to work within the Avera Health system after earning their bachelor’s degree in nursing.

Collaboration with the Nano Nagle Online School of Nursing at St. Ambrose University in Davenport, IA, provides nursing students with sponsorship dollars to help pay tuition costs with a three-year work commitment.

Nursing Degree in Three

Avera, Bishop O’Gorman Catholic High School and Mount Marty University have collaborated to create the Nursing Degree in Three program, an opportunity for O’Gorman students to potentially graduate with a Bachelor of Science in nursing (BSN) in three years.

The program has the benefit of generating a pipeline of well-trained nurses with roots in South Dakota. O'Gorman High School students can begin taking specific advanced placement (AP) and dual credit courses through Mount Marty in their junior year, which can count as credit for a BSN degree. If they take all the prescribed classes, they will graduate from Mount Marty with a BSN in three years instead of four.

Simulation Centers

Aberdeen: Northern State University’s Business and Health Innovation Center is home to an Avera-supported simulation center, a core aspect of NSU’s new Bachelor of Science in nursing program. Six simulation suites and an eight-bed skills lab, equipped with tools like realistic patient manikins and virtual reality, help students learn in a hands-on, immersive environment.

Pierre: A new nursing simulation center in Pierre is a collaborative effort between Avera, Lake Area Technical College and Capital City Campus aimed at strengthening the future health care workforce. Supported by an Avera donation, the simulation lab gives students hands-on training using advanced technology in a setting designed to replicate real patient care scenarios. The space includes advanced manikins, modern medical equipment and a 3D visualization tool.

Avera Academy

The Avera Academy allows high school students to earn high school and college credit hours while gaining real-time exposure to careers in health care. It’s a collaboration between Avera, Sioux Falls Public Schools and Southeast Technical College.

Each year, program leaders select 24 high school seniors from the Sioux Falls School District to take part. They spend Friday mornings at Avera facilities where they explore health care careers and see firsthand what health care professionals do. Avera Academy has been expanded to other regions within the Avera system in different versions that fit their needs, for example, day camps.

South Dakota Agricultural and Rural Leadership Program Sponsor

Avera is a sponsor of the South Dakota Agricultural and Rural Leadership Program (SDARL), which takes a cohort of adult learners on an 18-month leadership journey, with a new class seated every two years.

Seminars are held across South Dakota, as well as Washington, D.C., and time spent in a foreign country to examine the global nature of agriculture and the challenges of feeding the world. Participants emerge from the program prepared to lead their communities and the state, and make significant contributions to agriculture nationally and globally.

Marshall Partnership for Nursing Education

In response to increasing demand from prospective students in Marshall, MN, the Southwest Minnesota State University (SMSU) Nursing Department is developing a four-year bachelor’s degree in nursing in partnership with Avera Health. SMSU currently offers the RN to BSN program as well as the master of science in nursing education. By combining the clinical expertise of Avera with the academic excellence of SMSU, the program will deliver a robust educational experience that meets the highest standards of health care education.

Avera and SMSU are exploring ways our organizations could partner around simulation lab resources, clinical rotations and more.

Health Care Careers

Help deliver superior health care or provide outstanding support for those who do at Avera. Search Careers

Investing in Better Health Care

Avera invests in people, programs, technology and infrastructure that enable us to carry out our health ministry with the latest technology and state-of-the-art space.

Women’s and Children’s

In early 2027, Avera McKennan will move into new space created for Women’s and Children’s services, after a two-year construction project to create a six-story tower east of the existing hospital.

Avera is grateful for a historic $35 million gift from philanthropist, entrepreneur and child health advocate B. Thomas Golisano. This transformative contribution to the Tomorrow’s Promise Campaign supports pediatric care for the next generation. It is the largest single gift in Avera’s history. In recognition of Mr. Golisano’s investment, the new children’s hospital within the patient care tower at Avera McKennan will be named the Avera Golisano Children’s Hospital.

The six-story, $165 million patient care tower is dedicated to the care of women, newborns, children and families, significantly expanding capacity and enhancing care delivery across the region.

Collage of children and Thomas Golisano.

Avera Cancer Institute Yankton

Avera Cancer Institute in Yankton

The opening of the Ness Family Center, home to Avera Cancer Institute in Yankton, marks a new era of cancer care for the Yankton community.

The new Avera Cancer Institute location offers medical oncology, radiation oncology, chemotherapy infusion, clinical research, genetic counseling and other support services in one location instead of across two locations in Yankton. Having all services in one place aligns the Yankton center with Avera’s oncology locations in Aberdeen, Mitchell, Pierre and Sioux Falls, SD, and Marshall, MN, ensuring that patients receive the same, consistent experience.

Avera Cancer Institute’s six regional centers and dozens of outreach and telemedicine sites make up the only accredited cancer care network in the region, with accreditations from the American College of Surgeons Commission on Cancer (COC) and the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI).

Space Dedicated to Digestive Health, Orthopedics

Avera has opened Pavilion 2, a new medical office building at the Avera on Louise Health Campus in Sioux Falls. With a focus on offering consumer-friendly and accessible health care in the community, the three-story Pavilion 2 is home to the Avera Digestive Health Center and Avera’s gastroenterology specialists.

Pavilion 2 provides 127,000 square feet of patient care space. Its ground floor is dedicated to gastrointestinal (GI) procedures, such as colonoscopy, upper endoscopy and specialized procedures. This added space allows Avera to increase GI procedures by 100%. The second floor houses the Avera gastroenterology clinic, with capacity for additional growth.

Specialty care in orthopedics is now the main focus of the former Avera Specialty Hospital, which has been renamed Avera Orthopedic Hospital. Since 2016, Avera has built the region’s largest team of orthopedic providers.

Avera Orthopedic Hospital, Sioux Falls, SD

CNOS specialty health care in Sioux City, IA.

Avera Places Strategic Priority on Growth

Broadening the geographic reach of Avera is one of five pillars in our three-year strategic plan. Growth is important to the mission of Avera to have a positive impact in the lives and health of persons and communities. When we expand and enhance facilities or partner with hospitals and clinics in more communities, we can have a greater impact and improve accessibility to high-quality health care.

Avera is thoughtful and discerning about growth opportunities, ensuring alignment with our mission, a good cultural fit, a strong commitment to quality, and more.

Avera Continuum of Care

Infographic showing various statistics about Avera.

2026 by the Numbers

  • 44,262 inpatient discharges
  • 1,248,782 outpatient visits
  • 2,153,865clinic visits
  • 3,446,909total patient visits

Celebrating Excellence

Avera Transitions to Epic Electronic Health Information System

On May 30, Avera transitioned to the Epic electronic health information system, giving patients a new and more robust portal known as Avera MyChart.

Avera MyChart is a secure online health connection where patients can see their medications, test results, visit history, upcoming appointments, medical bills, price estimates, health insurance information including their virtual insurance card, and more, all in one place — even if they’ve been seen at multiple health care organizations. 

“This is a transformational project for Avera. What we’ve built together is a stronger, more connected system that will serve our patients and communities for decades to come,” said Kevin Post, DO, Avera’s Chief Medical Officer. “At Avera, our vision to provide high-quality, cost-effective care reflective of Gospel values has always been at the heart of what we do. With Epic, we will build on this vision by enhancing our ability to personalize every interaction.”

Avera MyChart mobile device desktop

Illuminate strategic plan and description.

Illuminate Strategic Plan

Avera continues to make meaningful progress on the initiatives of our three-year strategic plan, known as Illuminate.

Our strategic plan is a roadmap that sets direction and focus for Avera. It’s a framework for making consistent, aligned decisions that move us toward our envisioned future with growth, quality enhancements, innovative care and deeper community engagement.  

The five pillars of Illuminate are:

  • Exceptional Patient, Employee and Community Experience
  • Dynamic Physician and Provider Enterprise
  • Innovative Care Models Across the Continuum
  • Broaden Geographic Reach
  • Leadership and Essentiality

Many of Avera’s initiatives over the past year are part of Illuminate, including new partnerships, the Epic electronic health information system, successful physician recruitment, and new patient safety programs.

Enhancing the Patient Care and Experience

Avera’s Quality Journey

At Avera, providing quality care is our top priority. We embrace the philosophy of a just culture, encouraging learning and improvement while strengthening the systems that help our teams deliver excellent care to each and every patient.

Avera continues to expand the quality and safety focus throughout the continuum of services, including our hospitals, primary and specialty care clinics, home care and long-term care.

Current quality initiatives include:

  • Good Catch Awards: Caregivers are human, too. Avera recognizes individuals who speak up before errors happen, building upon a culture of safety for Avera patients and employees.
  • Patient Experience: Nurse leader rounding and bedside safety handoffs are core principles of care delivery to strengthen communication, safety and patient engagement.
  • System Safety Huddle: This huddle identifies possible safety issues, finds solutions and works to improve patient safety across the Avera system.

Learn more about quality at Avera

Integration through Avera Health Plans

Avera Health is an integrated system of care. This means that our hospitals, clinics, physicians, leaders and our health insurance company all work together for the benefit of our patients.

For Avera, the members of Avera Health Plans are an important group we serve. This includes coverage for individuals and families, small and large employer groups, and Medicare Supplement insurance.

Great care begins with prevention and ensuring that members receive the full benefit of their health insurance plan when it comes to preventive care — like yearly check-ups and health screening tests and exams. Access to 60+ medical specialties ensures members can get the care they need close to home.

Our health insurance company knows our physicians and clinicians, and likewise, our care teams know our insurance plans. We work together for better health and well-being for all who choose Avera.

More Avera Quality News

Awards & Recognitions

Avera’s high quality in care and service is validated by numerous recognitions received from external organizations. Below, awards and recognition are listed for the Avera system as well as our individual facilities. View Awards

Generosity Makes a Difference.

Support your community’s health by giving to lifesaving services. Donate to the Avera Foundation. Donate