Jan. 8, 2024

By his own admission, it felt like the start of an episode of “Undercover Boss.”

Thanksgiving weekend, barely a month into his role as CEO of Avera Health, Jim Dover found himself registering for a visit to an emergency department at his own organization.

“A classic weekend warrior” injury is how the avid tennis player describes the situation that drove him to 26th Street and Marion Road, where initially “I showed up, and they treated me fantastic, and they didn’t even know who it was,” he said. “They were hitting on all cylinders – coming from Michigan, I’ll use an automotive metaphor – I’m awed by the care they give.”

While his own patient record now reflects visits to the ER, orthopedic sports medicine, the Avera Human Performance Center, physical therapy and the “medical supply company for the compression sleeve,” Dover’s initial dive into the rest of Avera Health from a leadership standpoint appears just as comprehensive.

Since joining the Sioux Falls-based health system in late October 2023 from Sparrow Health in Lansing, Michigan, the veteran health care executive has visited every Avera region — and now is going back for additional tours — spoke with numerous front-line staff and delivered his team a list of questions he describes as “anything from the mundane to the serious.”

“I’ve been on a seek-to-understand tour,” he said, combining the firsthand look with a data-driven study of metrics he compares to peeling away the layers of an onion.

“The biggest mistake a new system CEO can make coming in is thinking they know stuff when in reality you know nothing.”

‘My first true love’

A scientist’s curiosity lives in Dover’s DNA with good reason.

His father, Jerry, earned a degree in physics from Grinnell College in Iowa and moved to California’s Bay Area, where Dover, the youngest of six, would be born. Jerry Dover’s task: assisting the Department of Defense and pilot Chuck Yeager in the first airplane flight faster than the speed of sound.

Fighter pilot Chuck Yeager via Wikipedia

After completing it in 1947, the specialist in telemetry went on to do work supporting the Apollo lunar missions through the early 1970s.

“I grew up with ‘Scientific American’ on the table. I still read it,” Dover said. “Science is my first true love. I love science. I love health care. I’m a curious individual, so I ask a lot of questions, and love the advancements we make on a daily basis.”

When the Apollo mission was shut down, the family moved to Idaho, where Dover’s father shifted to running a potato manufacturing plant and 14-year-old Jim was introduced to life in a town of 10,000 people on the Snake River. His high school summer jobs involved hauling hay and moving irrigation lines in potato fields.

“I became an avid outdoorsperson but loved the rural (life),” he said.

He attended the University of Idaho with a plan to become a medical laboratory clinical scientist, but after working as a phlebotomist EKG technician while a student, “I found out I love working in the hospital but didn’t see myself working in the lab,” he said. “I wanted to expand my ability to work with others.”

His career subsequently would crisscross the country, with leadership roles for Hospital Sisters Health System in Springfield, Illinois; Daughters of Charity Health System in Los Altos Hills, California; St. Anthony North Hospital in Westminster, Colorado; and several additional health systems on the West Coast.

“I love the rural. I’ve worked urban. I worked in San Jose, which is the most advanced managed care market in the nation, a very, very competitive market. I worked in Denver. So I feel have worked in urban and feel very comfortable in that market, but what I love about Avera is our integrated system,” he said.

Avera move

With more than 30 years of experience in Catholic health care, Dover knew the Avera name long before a recruiter approached him about the potential of becoming its third CEO.

“I was aware of Avera for many years. I knew (prior CEOs) John Porter. I knew Bob Sutton. And I was always extremely impressed with the quality of the people I met from Avera,” he said. “The Benedictine and Presentation Sisters are well-known in Catholic health care for their devotion to care across the Upper Midwest and prairie.”

So when he got the call about potentially filling the role vacating by Sutton, who had to step down for health reasons, “I said ‘Absolutely.’ I jumped at the chance,” Dover said. “Once I did my interview and got a chance to meet the people and leadership and governance, I was so hopeful I’d be successful. I was, and I’m grateful every day.”

As a system, Avera includes $3 billion in annual revenue, more than 20,000 employees, a 1,200-member medical group, 37 hospitals, 200 clinics, 40 long-term care facilities, home care and hospice. The footprint includes locations in South Dakota, North Dakota, Minnesota, Iowa and Nebraska. Avera is also the region’s largest provider of behavioral health services and operates Avera Health Plans.

Sister Mary Kay Panowicz chaired the CEO selection committee and said in a statement announcing Dover’s hiring that she had a deep confidence in the process and in Dover’s selection.

Jim Dover at his commission, an event that includes gifts for the new CEO symbolic to Avera’s mission from the board and regional leaders. 

“For the Avera system members and the Avera board, it was paramount that we find a leader who is committed to Avera’s 125-year legacy of rural health care and our Gospel-based mission to improve the lives of those we serve,” Panowicz said. “In Jim Dover, we see an engaging and compassionate leader who will lead Avera into its next era of serving the community’s health, our dedicated employees and our outstanding medical community.”

Dover takes over at Avera at a time when health care’s financial tide has turned a bit, at least from the historic margin pressure of the immediate post-pandemic era.

“We ended 2023 in a positive space – that’s great. … We are continuing to trend positively. We are more efficient. We’re growing market share and market, and that helps a lot,” he said, adding both Moody’s Investors Service and S&P Global Ratings recently affirmed the system’s AA rating and stable outlook, while “80 percent of health systems in the country got a downgrade in the last two years. So we’re doing remarkably well. We have a super strong balance sheet. So we’re in an incredible, positive position.”

So look for what Dover called “a capital pause during COVID” to give way to new building.

“I expect we’re working through the strategic business plans to make some very significant capital investments,” he said.

That includes everything from hospital beds and equipment to IT infrastructure and the personnel needed to support growth. Among the first questions he asked as CEO, Dover wanted to know the numbers behind nursing.

“Right now, we have 700 vacancies for nurses just within Avera … and there are other health systems in the state with vacancies as well,” he said. “So we are super short, and when it comes to a business, you worry about supply chain … and I’m really worried this state is not producing enough nurses to meet the growth of the state and the number of nurses who are going to start retiring.”

In the immediate future, Dover will turn his focus to advancing a new three-year strategic plan for the system, what he calls his first, foremost and “single greatest leadership effort” for the organization.

“We want to skate to the puck, so where is that puck going to be three or four years from now?” he said. “That’s really what we test all our decisions against.”

He pointed to a deep interest in maintaining the system’s quality, commitment to research and accessibility of care regardless of geography.

“For us to be successful and continue to be a strong system, we have to have size and scale, and essentially we have that now,” Dover said, acknowledging that in a world of increasing health care mergers the question naturally arises “is Avera going to go away or be absorbed, and the answer is no. We have critical mass.”

As importantly, there’s a culture and mission that insulate from becoming part of an outside organization, he said, noting that although as a system Avera has existed only since 2000, every employee he has met has identified as part of “one Avera,” he said.

“You go into some systems and there’s an edge,” he continued.

“Maybe it’s our Catholic health care heritage and our belief in terms of our three values, and one is compassion and one is hospitality … but it’s real. Hospitality value is real at Avera. It doesn’t mean we’re not competitive business people, but it’s wonderful coming to work every day to a vocation where people truly believe in hospitality and kindness. The rest of the world is far short of that, so for me it’s a welcome reprieve.”

He and his wife, Maria, also are settling into Sioux Falls, which he calls “impressive.”

“The reinvigoration of the downtown is remarkable,” he said. “Clearly, the business community and the rest of the community in partnership with the mayor’s office and City Council … have a well thought out, coordinated vision on how to continue to grow Sioux Falls for the positive. The city gets it, the business community gets it, and they recognize it can’t be one without the other and they need each other.”

Leadership approach

As a individual, Dover describes himself with five core values that drive his leadership approach, beginning with humility.

“In my 40 years (in health care), each year that goes by, I recognize how much smarter other people are than me and how talented they are in their field,” he said. “The second (value) is compassion. That was sparked in me early on as a phlebotomist, and I’d see suffering in patients, and what really impacted me was the suffering of the families and the suffering of our own caregivers. They suffered quite a bit during the pandemic, and I don’t know if they’ve really recovered yet, so I have a great deal of compassion.”

The third value is excellence – “we owe it to our community and organization,” and he strives “to be an excellent leader every single day,” he said.

The fourth: faith. A practicing Catholic, he leans into his faith, especially when tested – like “during COVID, when I had 1.5 days left on hand of N95 masks and didn’t know where the next ones would come from,” he said.

The fifth value: joy, one he describes as a deliberate way to approach life and work – that already appears reflected in his new role.

“The people at Avera are so kind and giving, and their dedication to care for our population, whether you’re Sioux Falls or Pierre or Gregory, it’s just unwavering,” he said.

“I literally pinch myself every day. I can’t believe I get to have this role.”