Enjoy delicious soup, sandwiches and pie, pick up some homemade baked goods and support the Auxiliary’s efforts to provide equipment and services that benefit FRHS patients and residents.

Want to help? Donate your favorite baked goods! Donations can be dropped off at the Senior Citizen Center anytime after 8 AM on October 23.

Come eat, shop, donate and support healthcare in our community!

We’d love to hear your story and your support for our new hospital and clinic project.

Video Link: https://drive.google.com/drive/folders/1rAmzV3NIzMkOBkYg1s8MG8f0jrh7r57t

View the full PDF article here

A Message from CEO Courtney Unruh
A new hospital and clinic may be the most visible part of Freeman Regional Health Services’s (FRHS) plans for the future, but this journey did not begin with a building. It has been years of evaluating, listening, analyzing, and building the partnerships needed to preserve rural healthcare.

While FRHS is affiliated with Avera, Freeman Regional remains a locally governed organization. Because of our strength, FRHS is moving forward with financing the new hospital and clinic independently, without relying on Avera’s capital funding. Avera has endorsed the project and supports the hospital and clinic as the first phase of the healthcare campus.

FRHS has the ability to move this project forward independently – but it is not moving forward alone. We have assembled a team of experts to guide us through this journey.

We hope this timeline gives you a glimpse into the many years of work and decisions that brought us to this moment. This vision has been shaped by thoughtful planning, collaboration, and a continued commitment to the future of rural healthcare.

Sincerely, Courtney Unruh

2018 – REEVALUATING THE CAMPUS
The FRHS Board partnered with BWBR, an architectural firm specializing in healthcare, to evaluate the costs and benefits of remodeling the current campus versus building a new facility. The cost and limited lifespan of updating aging infrastructure, combined with the land-locked campus, lead BWBR to recommend a new healthcare campus.

2019 – LAND PURCHASE
Salem Mennonite Home (SMH) launched a capital campaign and purchased 20 acres along Highway 81 for future development.

By year end, financial projections determined that Freeman’s healthcare organizations could not independently fund an ideal future healthcare campus, reinforcing the need for collaboration, strategic partnerships, and a financially sustainable path forward.

2020 – EVALUATING PARTNERSHIP OPTIONS – KEEPING LEADERSHIP LOCAL
The FRHS Board carefully evaluated an Avera lease arrangement versus an affiliation agreement and chose to become an Avera affiliate – gaining access to Avera expertise and resources while intentionally preserving local governance. FRHS employees, including the CEO and administrative team, remain FRHS employees and are accountable to the locally-governed FRHS Board of Directors. Note: In 2011 the FRHS clinics signed a joint operating agreement with Avera to provide industry employment standards for doctors and advanced practice providers with FRHS clinics maintaining local governance.

FRHS purchased 20 acres adjacent to the SMH property along Highway 81.

2021 – SHARED CAMPUS VISION
On January 14, FRHS and SMH announced a shared vision for a future healthcare campus. Throughout the year, leaders discussed organizational structure and evaluated Avera’s proposed 25-year lease option.

FRHS initiated a strategic plan with an updated Mission, Vision, and Values.

By year-end, Avera encouraged Freeman’s healthcare organizations to work together before moving forward with a campus project under Avera.

2022 – NEGOTIATING A MERGER
FRHS and SMH spent the year working through the details needed to bring the organizations together.

FRHS received grant funding through the USDA Rural Hospital Technical Assistance Program championed by Senator Mike Rounds. Through this initiative experts evaluated FRHS financial and operational practices and identified opportunities to strengthen the revenue cycle, improve cash flow, and expand revenue-generating services.

“This work helped us identify practical ways to improve, putting FRHS in a stronger financial position to sustain local healthcare and plan confidently for the future.” – Phil Husher, FRHS CFO

Avera evaluated how to prioritize major rural capital projects, with the FRHS project ranking among its top rural priorities. While Avera proposed a lease option for a new hospital, clinic, and nursing home, this discussion did not include assisted living or independent living.

2023 – COMING TOGETHER, CARING FOR ALL
FRHS and SMH merged, providing a full continuum of care within one organization. Avera leadership changed and put major capital projects on hold. FRHS continued preparation for a new healthcare campus by visiting facilities with recent construction projects.

“When Avera paused its building projects, we kept moving forward. FRHS leaders, board members, and providers toured healthcare facilities in Gregory, Milbank, and Rock Rapids to learn from other rural communities including what worked well, what they would do differently, and what could benefit FRHS the most.” – Courtney Unruh, FRHS CEO/Administrator

2024 – PLANNING FOR THE FUTURE OF SENIOR LIVING
Leadership, medical providers, and board members continued learning by touring modern senior living facilities in several communities. Independent living, assisted living, and long-term care models were evaluated to understand how senior services could best fit within a unified healthcare campus.

2025 – AN INDEPENDENT & SUSTAINABLE FIRST STEP
Early in the year, a comprehensive financial analysis completed by healthcare auditing and advisory firm Eide Bailly was reviewed by the FRHS Board and Avera. The analysis determined that a new hospital and clinic would be the most sustainable first phase of the future healthcare campus. It was discussed that these areas generate the greatest share of revenue and cash flow, providing the strongest financial foundation for the organization and helping position FRHS to independently complete future phases of the campus plan.

“That financial analysis gave the board a clear path forward. Starting with the hospital and clinic gives FRHS the strongest financial foundation for the entire campus. By beginning with the services that generate the greatest revenue and cash flow, we are positioning the organization to remain financially strong and independent, and ultimately move toward the senior living and long-term care phases more quickly. We have realized, and so has Avera, that we can fund this independently.” – Steve Fuhrmann, FRHS Board Vice President

Avera’s representatives said that they strongly support the decision to build the hospital and clinic as the first phase and they endorsed FRHS moving forward with the project. Through the ongoing affiliate agreement, FRHS will continue to benefit from Avera’s healthcare expertise, resources, and support without having to rely on Avera’s capital planning process or timeline to move forward.

“Working with Avera is increasingly important as healthcare continues to change. Avera’s support confirms that Freeman Regional is a valued partner today. They care about our success in the future. Having a regional healthcare leader like Avera in our corner provides confidence as we move forward.” – Dr. Jay Allison, MD, FAAFP

APRIL | ARCHITECTS ENGAGED
The FRHS Board approved moving forward with BWBR Architects for conceptual planning, marking an important transition from years of study and discussion to active planning for the new hospital and clinic.

MAY | LISTENING TO SENIOR LIVING RESIDENTS
Lessons learned at facilities that offer independent and assisted living together led to individual conversations with each resident at the Walnut and Dewald Street Villages. Those conversations revealed residents’ strong desires to age in place. Rather than asking independent living residents to leave an apartment they loved, FRHS recognized an opportunity to bring assisted living services to them.

AUGUST | AGING IN PLACE
While the hospital and clinic were identified as the most financially sustainable first phase of the new campus, FRHS also recognized the need to improve senior living services in an economical and affordable way while the larger campus plan moves forward. Subsequently, following months of evaluation and resident conversations, the FRHS Board voted to move forward with transitioning independent living apartments at the Villages to support assisted living services – creating additional opportunities for residents to remain in familiar surroundings as their needs change.

OCTOBER | EXPLORING FINANCING OPTIONS
FRHS turned its attention toward determining the strongest financing strategy for the project. FRHS began discussions with Avera regarding potential financing partners and continued investigating financing and grant opportunities. FRHS also learned from rural healthcare projects in Mobridge and Bennett County in South Dakota and Sioux Center, Iowa.

NOVEMBER | BUILDING THE FINANCIAL PATH
FRHS interviewed five financial firms to evaluate financing strategies and expertise. Later, the Board selected Colliers to assist with the financing strategy for the new hospital and clinic.

DECEMBER | LEGISLATIVE SUPPORT
State legislators visited FRHS, learned more about the healthcare campus vision, and expressed excitement about the future investment in Freeman and the surrounding region.

“Your vision for building a new hospital and clinic is exciting. Building a new hospital drives economic development. First of all, it retains and creates jobs. Then think of the people who want to move to a community where there are a lot of employers in town and housing opportunities, a clinic and hospital, and long-term care facilities – all in your backyard. You don’t need to leave town for anything. Your timing is really good – celebrating 75 years and planning to be there for the next 75 years.” – Drew Peterson, SD State Representative, District 19

By the end of 2025, years of planning had produced: a clear first phase, confidence in FRHS’s ability to finance it independently, and a strategy to support the phased development of the overall healthcare campus.

2026 – MOVING THE VISION FORWARD
Throughout 2026, the focus shifted to assembling the right project team, advancing building design, evaluating financing options, and pursuing outside funding – all while maintaining local governance and financial independence.

JANUARY | HONORING THE PAST, CELEBRATING THE PRESENT
Black and white photos at the annual FRHS Gala honored 75 years of healthcare and set the stage for a formal announcement: FRHS is moving forward with plans for a new hospital and clinic and bringing assisted living services to the Walnut and Dewald Street Villages.

“This approach balances the immediate needs in our community while setting us up to be financially successful throughout each phase of building a new healthcare campus. This has been a long journey with a few detours and maybe a couple temporary roadblocks, but at the same time, FRHS has stayed on course and used the time to prepare financially, allowing us to remain independent in this project. That is where I see God in this project. He was working out the details, even when we thought they were roadblocks.” – Lori Uecker, FRHS Board President

MARCH | PURSUING FUNDING
FRHS requested approximately $13 million in federal Congressionally Directed Spending (CDS) through Senator Mike Rounds’ office to help offset project costs. Letters of support from Avera, the City of Freeman, Freeman Community Development Corporation, Vermeer, and the Hutchinson County Commissioners demonstrated broad regional support for continued investment in rural healthcare. Appropriations for CDS requests will be announced in the next six months.

APRIL | BUILDING THE TEAM
Construction manager interviews were conducted with the FRHS Building Project Committee and representatives from BWBR, Colliers and Avera. Because of their healthcare expertise and competitive bid, FRHS selected Journey Construction and authorized BWBR to begin the schematic design phase.

“I just wanted to thank and commend you and your team for the work you’re doing! You’ve done a great job keeping the new hospital project moving forward while also maintaining day to day operations.” – Cameron Becker, FRHS Board Member

JUNE | PROJECT GUIDANCE
FRHS hired the Tegra Group as an owner’s representative to champion and protect FRHS interests, navigate contracts, and keep the project aligned with FRHS’s goals.

“The thing I really appreciate in all of this is how leadership is surrounding the board with experts to make educated decisions.” – Lori Uecker, FRHS Board President

JULY | FINANCING & ARCHITECTURE MOVE FORWARD
To determine the best financing method, Colliers evaluated three models: bank placement, bond financing, and USDA financing. The FRHS Board moved forward with Colliers recommendations for bank placement and starting the design development phase. This phase allows the project to be accurately priced and prepared for construction documents.

“After all these years of planning and discussion, it is exciting to feel confident that we are taking the right path. We have done the work to understand what FRHS can responsibly support. This is a pivotal moment for Freeman Regional as we move from planning toward making this vision a reality.” – Dr. Jason Aanenson, FRHS Board Treasurer

AUGUST | CAMPUS PLAN MOVES FORWARD
FRHS submitted a Conditional Use Permit application to the City of Freeman to construct a hospital, clinic, helipad, future nursing home, and senior living.

Assisted Living residents transitioned to Walnut and Dewald Street Villages and Oakview Terrace assisted living facilities.

We will be sharing a construction timeline soon!

Hofer’s journey with Freeman Regional began during physician assistant school when she completed a three-month primary care rotation in 2015. Today, she’s bringing more than a decade of healthcare experience back to rural healthcare, where she looks forward to caring for her neighbors and serving the communities she knows so well.

Following graduation from the University of Nebraska Medical Center, Hofer joined Avera Medical Group’s Oncology & Hematology team, where she has spent more than 10 years caring for patients with complex medical conditions. She also gained valuable experience in urgent care, treating patients of all ages and a wide range of healthcare needs. Before becoming a physician assistant, she worked as both an Emergency Medical Technician and paramedic while earning her bachelor’s degree in biology from South Dakota State University. Those experiences helped shape the provider she is today and prepared her to care for patients in both the clinic and emergency department.

“I’m excited to return to Freeman Regional and serve the community close to home,” Hofer said. “I enjoy the variety that rural medicine provides and the opportunity to care for patients through every stage of life. Building lasting relationships with patients and their families is one of the most rewarding parts of being a provider.”

Hofer and her husband, Patrick, have three children—Sarah, Simon and Elijah—and are looking forward to welcoming their fourth child in December. Outside of work, she enjoys spending time with her family, helping on the farm and tackling home improvement projects.

“We’re excited to welcome Laura to Freeman Regional Health Services,” said Karissa Podzimek, Clinic Manager. “Laura brings a unique combination of experience in emergency medicine, urgent care and oncology that will be an incredible asset to our patients and residents. Beyond her clinical expertise, she has a genuine passion for rural healthcare and building meaningful relationships with patients and families. We’re thrilled to have someone with her experience and compassion joining our provider team.”

Guided by Those We Serve
Freeman Regional Health Services (FRHS) is excited to celebrate the addition of assisted living care to the Walnut and Dewald Street Villages and Oakview Terrace – a continuation of Freeman’s tradition of neighbors caring for neighbors close to home.
To address the need for new assisted living options, FRHS leadership explored new models of senior care in 2024. Hospital leaders, providers, and board members toured senior living campuses across South Dakota that combine independent and assisted living. Inspired by what they learned, CEO Courtney Unruh and Senior Living Assistant Administrator Amanda Mettler met with each Village resident in May of 2025 to understand their preferences for future care.

“There was an overwhelming consensus that they did not wish to move again,” Unruh said. “Residents described moving as emotionally and physically challenging and expressed a strong desire to age in place.”

“These are important changes and will make living here even better – and it’s already good!” said Dewald Village residents Delmer and Shirley Hofer

“I am pleased I can stay here longer than I previously thought or expected. I can feel at home and settle in.” Walnut Village resident Darlene Bauer

Rather than asking residents to leave a place they loved, FRHS recognized an opportunity to bring additional services to them. “This approach allows us to strengthen senior living while supporting residents’ independence, dignity, and desires,” Mettler added.

The opportunity to adapt the Villages today is rooted in the vision of community leaders who planned them nearly three decades ago. “The Villages were thoughtfully designed, making the transition to assisted living a smooth process,” Unruh said. “The vision of the 1996 FRHS Board of Directors and CEO James Krehbiel created a facility that continues to meet our community’s changing needs 30 years later.”

In the summer of 2025, FRHS leadership evaluated how the Villages could be modified for assisted living. By August, the FRHS Board of Directors approved moving the project forward.

“By listening to our residents and thoughtfully evaluating how to build on what we already have, we’re creating a model of care that reflects the needs of today’s seniors while honoring the legacy that brought us here,” said Cindi Mutchelknaus, FRHS Board Member.

Since January, the FRHS maintenance team and local contractors have completed several improvements, including a nurses’ station, security system, and sprinkler installation. Additional enhancements include expanded dining, housekeeping, and laundry services, as well as a new call light system.

“We’re grateful for the support of the Freeman Community Foundation,” Mettler said. “Their grant is funding food warming equipment and steam tables that will allow us to serve three hot meals each day.”

FRHS also recognizes the ongoing need for independent living in our community. While today’s focus is creating new assisted living options, leadership continues to evaluate ways to expand independent and senior housing so residents can continue calling Freeman home through every stage of life.

Continuing the Journey
A decade ago, the Salem Mennonite Home recognized that the aging building would eventually need to transition to meet the changing needs and expectations of future generations. Now with less than 10 residents remaining, the time for that transition has come, and two new assisted living options will be ready to welcome each resident.

In addition to making the Villages assisted living capable, FRHS also received state approval to provide assisted living services at Oakview Terrace. A newly refreshed wing is being prepared to provide another welcoming option for residents whose needs are best met in that setting.

“Every resident has a unique story, and every transition has been approached with that in mind,” Mettler said. “We are walking alongside them and their families with compassion and care – listening, answering questions, and helping each person find the setting that meets their needs. Our goal is for every resident to feel supported, respected, and cherished.”

Some residents will move to the Villages, while others will make Oakview Terrace their new home, where compassionate care teams and welcoming environments await. The transition also allows familiar caregivers to continue serving residents they know so well. Assisted living team members from Freeman Regional Assisted Living will continue providing care at the Villages and Oakview Terrace.

Freeman Regional Assisted Living, which has operated within the former Salem Mennonite Home building, will move operations by the end of the summer. Future plans for the building will be prayerfully and thoughtfully considered in the months ahead.

“The Salem Mennonite Home building has faithfully served generations of residents, families, and caregivers,” Unruh said. “The people who lived and worked there created a legacy of compassion, faith, and service that FRHS is honored to carry forward.”

Honoring the Salem Mennonite Home Legacy – A Message from CEO Courtney Unruh
For generations, the Salem Mennonite Home has been woven into the story of our community. It has been far more than a building – it has been a place of faith, service, family, friendship, and care. For many, it was simply home.

We are planning a time to celebrate this ministry and legacy by sharing memories and honoring those who generously contributed over the years. Please watch the Freeman Courier for an announcement next month.

As we continue Freeman’s healthcare journey, we carry forward the responsibility of continuing the Salem Mennonite Home’s tradition of exceptional care while creating new places for our neighbors to call home. This is a tender time of transition where we can move forward with compassion, careful planning, and your support.

We invite you to join us on this journey – beginning with these new assisted living opportunities and continuing toward a new healthcare campus that will strengthen care, expand services, and support our communities for the next 75 years. Together, we can honor the past, celebrate the present, and build tomorrow together.

Sincerely,
Courtney Unruh, CEO/Administrator

P.S. While buildings and campuses may change over time, our mission and commitment to the people who call FRHS home—our residents, patients, families, employees, and communities —remain the same.

It is our mission to provide high-quality, compassionate care for all ages to positively impact the lives, health, and wellness of our patients, residents, employees, and communities.

For our Attitude Award, some of the things we look for are: demonstrating a welcoming & cheerful presence, being courteous and understanding, and considering each encounter a privilege to make a positive impact. Congratulations, Audra, this is a well-deserved honor for all you do!

For our Respect Award, some of the things we look for are: listening attentively without interrupting, interacts with honesty and sincerity to build trust and is accountable to others in work and actions. Congratulations, Kim, you’re commitment to FRHS, our patients and residents is impressive and we thank you!

For our Excellence Award, some of the things we look for are: goes above and beyond in duties and interactions, and represents FRHS positively. Congratulations, Cary, you check off all these items and more! Thanks for getting it all done!

Well-child exams provide a comprehensive evaluation of a child’s overall health and development and often include everything needed for a sports physical—plus much more. These visits help ensure children are healthy, up to date on immunizations, and ready for a successful school year.

Upcoming clinic dates include:

• Freeman: July 15, 22 and 29
• Marion: July 14
• Menno: July 14
• Bridgewater: July 16

Appointments may be scheduled at any of Freeman Regional’s four Rural Medical Clinic locations by calling 605-925-4000.

A well-child exam offers several benefits beyond a standard sports physical, including:

• Complete head-to-toe examination, including vital signs
• Review of allergies and medications
• Review and administration of recommended immunizations
• Evaluation of medical and social history
• Education on healthy lifestyles and behaviors
• Sports participation clearance when needed

Many well-child exams are covered by health insurance, making them a convenient and cost-effective option for families.

Students are encouraged to bring:

• A parent or guardian for consent
• Completed school or sports physical forms (if applicable)
• Insurance card for well-child exams

Sports physicals are available for $30 cash on the day of service and are not billed to insurance.

For questions or to schedule an appointment, call 605-925-4000.

Designed for youth ages 11–16, this educational program will provide participants with the skills and confidence needed to become responsible and capable babysitters. As families throughout our communities continue to seek qualified childcare providers, this training offers young people an opportunity to gain valuable knowledge and practical skills while preparing for future babysitting opportunities.

The clinic will cover a variety of important topics, including:

• Caregiving and Safety
• Age-Appropriate Activities
• Diapering and Feeding
• Basic First Aid and CPR
• Nutrition Basics
• And More

“Reliable babysitters are an important resource for families, and this clinic helps equip youth with the skills they need to provide safe, responsible care,” said Kayla Pavel, FRHS Clinical Nurse Educator. “Participants will leave with practical knowledge that can help them feel confident and prepared when caring for children.”

The cost to attend is $25 per participant. Students should bring a sack lunch.

Pre-registration is required, and participation is limited to ensure a quality learning experience. Interested families are encouraged to register early to reserve a spot.

Click here to register your child today!