Avera at Home Southwest Minnesota
A hospice in Marshall, Minnesota 56258
300 South Bruce Street, Marshall, Minnesota 56258. (507) 537-7070.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 1 deficiency cited in the last three years
- 4of 5 family caregiver rating
- 10of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
What did inspectors find?
1 deficiency cited in the last three years
The middle of the 8 hospices serving ZIP code 56258 had 2.
The last inspection on record was on Nov 26, 2025: a recertification inspection by the state.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
When those deficiencies happened
1 deficiency in 1 month of the last 36. Last cited Nov 2025. Most serious: Standard-level. The last 3 years, to Oct 27, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Nov | Dec | ||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
Each deficiency, as cited
Rule titles as CMS’s inspectors cite them, set in sentence case.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Nov 26, 2025: recertification inspection by the state1 deficiency
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Supervision of hospice aides (42 CFR 418.76(h)(1)(i))
The inspectors’ words, 576 words
“Based on interview and record review, the agency failed to ensure registered nurse (RN) supervisory visits were made at least every 14 days for 5 of 14 patients (P2, P8, P10, P11, and P14) patients in the sample who received home health aide (HHA) services. P2 was admitted for hospice services on 6/4/25, with diagnoses that included gastrointestinal hemorrhage, Alzheimers, vascular dementia, chronic kidney disease, diabetes, and congestive heart failure. The current plan of care indicated P2 received skilled nurse services twice weekly. The plan of care also indicated the patient received home health aide (HHA) services twice weekly to assist the patient with personal cares. P2’s medical record indicated the registered nurse (RN) had completed a supervisory visit on 6/23/25. The HHA visited the patient twice weekly, The RN continued with twice weekly visits, however, there was no supervisory visit completed again until 8/11/25.P8 was admitted for hospice services on 7/15/25, with diagnoses that included pneumonia, dementia, malnutrition, chronic obstructive pulmonary disease (COPD) and osteoporosis. The current plan of care indicated P8 received skilled nurse services twice weekly. The plan of care also indicated the patient received HHA services weekly to assist the patient with personal cares. P8’s medical record indicated the RN had completed a supervisory visit on 8/1/25. The HHA visited P8 weekly, the RN visited twice weekly, however the next supervisory visit was completed on 8/25/25. P10 was admitted for hospice services on 7/23/25, with diagnoses that included COPD, severe protein-calorie malnutrition, anxiety and chronic respiratory failure. The current plan of care indicated P10 received skilled nurse services twice weekly. The plan of care also indicated the patient received HHA services twice weekly to assist the patient with personal cares.P10’s medical record indicated the RN had completed a supervisory visit on 9/2/25. The next supervisory visit was completed on 9/19/25.P11 was admitted for hospice services on 6/30/25, with diagnoses that included senile degeneration of brain, dementia, and osteoporosis. The current plan of care indicated P11 received skilled nurse services twice weekly. The plan of care also indicated the patient received HHA services twice weekly to assist the patient with personal cares.P11’s medical record indicated the RN had completed a supervisory visit on 7/3/25. The next supervisory visit was completed on 7/28/25.P14 was admitted for hospice services on 6/27/25, with diagnoses that included senile degeneration of brain, dementia, basal cell carcinoma, heart failure, and osteoporosis. The current plan of care indicated P14 received skilled nurse services twice weekly. The plan of care also indicated the patient received HHA services twice weekly to assist the patient with personal cares.P14’s medical record indicated the RN had completed a supervisory visit on 8/31/25. P14’s medical record failed to indicate another supervisory visit was completed. When interviewed on 9/23/25, at 2:15 p.m. RN-A stated the supervisory visit doesn’t always trigger to be completed, at some point there was a change, it’s gotten easier to miss the supervisory visits. During an interview on 9/24/25, at 10:08 a.m. RN-B stated every fourteen days there is a task that drops into the system for a supervisory visit to be completed. The task drops after the nurse completed the documentation for their visit. Some nurses don’t use the tasks they just document the supervisory visit in the notes, that won’t trigger a task for the next supervisory visit. The system is “glitchy”. Provider policy Care Assistant/Aide Supervisory Visits policy indicated supervision of aide services must occur at least every 14 days.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Nov 26, 2025 | Recertification inspection by the state | 1 deficiency cited |
Is it certified?
- Medicare-certified hospice since Jun 19, 2015.
- Ownership: non-profit.
- No For hospices, home health agencies, hospitals and dialysis facilities, CMS writes deficiencies at two levels. Standard is the usual one; condition-level is the more serious, when a problem is serious enough that the provider doesn’t meet a whole condition of taking part in Medicare. Source: CMS, State Operations Manual. deficiency or CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3. on record in the last three years.
CMS, Hospice General Information. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Has anything been proven against it?
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- 0 deficiencies cited in the last three years came from inspections that included a complaint investigation.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Who does the caring?
- From Medicare claims (Jan 1, 2023 to Dec 31, 2024): 17.3 nurse care minutes per routine home care day, 8.7% of skilled nursing minutes at weekends and a visit near death for 97% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 29% at home, 11% in assisted living, 60% in a nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 17.3 min |
| Skilled nursing minutes at weekends | 8.7% |
| Visits near death | 97.0% of patients who died |
Who owns it?
- Avera Health owns 100% directly since Jun 15, 1992.
- 12 owners or officers are people: Jill Vroman (corporate director); Debra Ann Streier (corporate officer); Debra Ann Streier (runs it (operational or managerial control)); Tim O’leary (corporate director); Jodelle A Zimmerman (corporate director); Sharon Hennen (corporate director); Amanda Sieling (corporate director); Karie Engle Novak (corporate director); Lavonne Annette Koenen (corporate director); Christy Ann Coudron (corporate officer); Thomas Matthew Lorang (corporate director); Curtis Ronald Louwagie (corporate director).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, Hospice All Owners and Hospice Enrollments. Released Sep 29, 2026. Updated quarterly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Avera Health | Owns 5% or more directly | 100% | Jun 15, 1992 |
What do families say?
- Family caregivers rate it 4 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 88% rated it 9 or 10 out of 10, and 88% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 97.14% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 85.8% had visits from a nurse or social worker on at least 2 of their last 3 days (Jan 1, 2023 to Dec 31, 2024).
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | Rating |
|---|---|
| Family caregiver survey ratingCMS star rating from its survey of patients’ family caregivers, 1 to 5 | 4 of 5 |
| Hospice Care IndexCMS’s Hospice Care Index, 0 to 10 (higher is better): a point for each of ten measures from Medicare claims on which the hospice meets CMS’s threshold | 10 of 10 |
How does it compare nearby?
- Of the 8 hospices CMS’s data show serving patients in ZIP code 56258, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 2; this one had 1.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
| Place | Deficiencies, 3 years |
|---|---|
| Prairie Home Hospice | Not given |
| Avera at Home Southwest Minnesota This hospice | 1 |
| Allina Health Hospice & Palliative Care | 13 |
| Hospice of Murray County Inc. | Not given |
| Winona Area Hospice Services | 3 |
| Good Shepherd Hospice | 0 |
| Moments Hospice | 9 |
| Sanford Hospice | 1 |
What the record doesn’t say
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- Only complaints that led to a citation appear; complaints that didn’t aren’t published.
- CMS ended its Special Focus Program for hospices with serious problems on Feb 14, 2025, so no hospice is marked as one.
- Hospice quality measures have a gap from October 2025: CMS replaced its patient assessment then, and public results from the new one (HOPE) are expected around November 2027.
Sources
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Centers for Medicare & Medicaid Services, Hospice General Information (yc9t-dgbk).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Provider Data (252m-zfp9).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, CAHPS Hospice Survey (gxki-hrr8).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, QCOR hospice inspection reports (Hospice Survey Reports - Oct 2021 through Sep 2026.xlsx).
Released Oct 23, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice All Owners (e983965e-1603-4cb8-82b5-c40090e380d1).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Enrollments (25704213-e833-4b8b-9dbc-58dd17149209).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice ZIP Data (95rg-2usp).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Oct 27, 2026.
From the hospice
The public record above comes first. Anything the hospice adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the hospice will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the hospice”, and paying will never change a finding, a rating or the order of results.