Longtime Avera Health president and CEO John Porter is retiring.

Porter will step down a year from now, as he turns 70, or when a successor is named.

“It’s been building up,” he said. “And at some point, you finally have to say yes. My wife and I are celebrating our 50th anniversary next year … and I’m starting to miss (my grandchildren) growing up, so it may be time to say this has been fun. It’s been a real calling, and we’ve enjoyed it. The sisters have treated us like family. But it is time to look back and maybe look at the next phase of my life.”

His retirement caps a career with the Catholic health system that has spanned more than four decades. He was Avera’s first CEO, taking over in 2000 after facilitating the process of bringing the Benedictine Sisters of Yankton and the Presentation Sisters of Aberdeen together to form the system.

“John has had an amazing 44-year career with Avera. He has been pivotal in the formation of our health system, its tremendous growth over the past four decades and the development of innovative programs,” said Sister Mary Kay Panowicz, Avera System Members chair.

Porter considers working with the sisters to develop their health ministries as “strong, viable, sustainable missions” as his favorite part of the career.

As part of his legal work, he helped the Presentation Sisters form one of the nation’s first health systems in the late 1970s. He helped the Benedictine Sisters form one in the late 1980s. And in the late 1990s, he helped bring the two together.

“There was really no connection at all between them,” he said. “It was almost like they competed with each other. They didn’t share much of anything. They were always competing for personnel.”

The union helped the systems achieve scale and avoid becoming part of other larger health care organizations while building one centered around their shared mission.

Porter is the one who helped come up with the name Avera, after a naming firm’s suggestions didn’t resonate.

“I’ve got a little Latin background, so I got out my Latin dictionary and the name ‘Avere’ is an old Latin salutation that means ‘be well.’ ”

The name stuck, and the system grew. It now totals 17,000 employees, making it the largest public or private employer in South Dakota and the largest female-founded organization in the state. Its 330-location footprint spans five states and 100 communities.

“We have seen tremendous growth,” Porter said. “Even though we’ve been through the same challenges as everyone with the Affordable Care Act and Medicare changes, I think we’ve done an excellent job of stewardship, protecting the assets and our employees, and continuing to see growth.”

He counts establishing Avera eCare services, health insurance plans and centralized service lines as among his greatest accomplishments.

Porter was introduced to his future leaders — the sisters — while still in college at USD and working at a law firm in Yankton. His mentor and future law partner, Don Bierle, took him to a board meeting for a Catholic hospital in Montana. Afterward, at a picnic, he met several members of the Presentation order, including Sister Joan Reichelt, who would go on to become Avera’s highest-ranking female executive leader, its executive vice president of culture.

Reichelt, whom Porter calls his confidante and cajoler, has joked for years she will retire one day after he does. She backtracked on it a bit now that his time line is set.

“I really don’t ever want to retire. I don’t want to quit work. This is my family,” she said, joking that she has enjoyed Porter as a leader “99.5 percent of the time.” She appreciates his ability to listen and enjoys the give-and-take they have established in their shared leadership.

“Somebody said we bicker,” she said. “No, we banter.”

Reichelt will be part of the group choosing Porter’s successor, which will include the six sisters in system leadership plus input from representatives of the Avera Health board.

“I’m looking for someone who doesn’t dictate to people, who understands health care and can understand our mission,” she said. “I want someone with a sense of humor, not someone who flies off the handle — just a good, decent person with a good business sense but who understands that we’re a ministry.”

While a firm will be hired to guide the search, it’s possible an internal candidate could be chosen in lieu of a broader search, Porter said. That has not been determined.

He acknowledges that because the system has never experienced a CEO transition, “there’s nervousness everywhere, but we are setting ourselves up to be inclusive, prayerful and reflective.”

The system is on solid ground financially, he added. While other hospitals and health systems – including those with Catholic roots – have consolidated in recent years, Avera is “extremely comfortable in our own skin,” he said.

“I don’t think you would see us becoming part of the next mega-merger. Would we look at selling out to a larger (system)?” he asked, shaking his head in response. “That’s what brought about Avera to begin with. The two involved were looking at needing to be part of something larger and then they wouldn’t be that involved. And neither order had interest in that, and I would say today they have no interest in that.”

The next leader is inheriting an organization with a unique culture, he added.

“And it’s entirely different from Sanford or Rapid City or the bigger groups out there, and you have to be protective of that, knowing whoever comes in, some of that will change, and that’s good, but you have to be watchful. We’re not in a position where we need a change agent because the house is burning. You just keep building on what the sisters and us and Avera have built on for 100 years. Ten years from now, Avera will be a much bigger footprint physically or virtually, and I think that’s the vision everybody shares.”