AITKIN COMMUNITY HOSPITAL INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
AITKIN COMMUNITY HOSPITAL INC (EIN 41-0745522)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-10
IRS object ID
202002239349300815
Schema version
2018v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-08-10T09:23:38-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST FIRST STREET SUITE 700AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP558021926ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410745522EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AITKIN COMMUNITY HOSPITAL DBABusinessNameLine1Txt
Business Name Line2RIVERWOOD HEALTHCARE CENTERBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlAITKBusinessNameControlTxt
Phone2189272121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BUNKER HILL DRIVEAddressLine1Txt
CityAITKINCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56431ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCASEY JOHNSONPersonNm
Person TitleCFOPersonTitleTxt
Phone2189272121PhoneNum
Signature2020-08-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIE BOYERPreparerPersonNm
PTINP01278549PTIN
Phone2187275025PhoneNum
Preparation2020-08-07PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.3.59.197IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-07IPDt
IP Tm08:36:01IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdA3EA2213F362026AE26E78146383F0EC02CC4472AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTODD SANDBERGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BUNKER HILL DRIVEAddressLine1Txt
CityAITKINCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56431ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$78,519,348GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RIVERWOODHEALTHCARE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1948FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionINPATIENT AND OUTPATIENT MEDICAL CARE AND THREE PRIMARY CARE CLINICS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee477TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$108,110TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$416,723PYContributionsGrantsAmt
CY Contributions Grants$1,114,392CYContributionsGrantsAmt
PY Program Service Revenue$64,335,185PYProgramServiceRevenueAmt
CY Program Service Revenue$71,039,361CYProgramServiceRevenueAmt
PY Investment Income$2,022,627PYInvestmentIncomeAmt
CY Investment Income$2,649,730CYInvestmentIncomeAmt
PY Other Revenue$354,568PYOtherRevenueAmt
CY Other Revenue$474,115CYOtherRevenueAmt
PY Total Revenue$67,129,103PYTotalRevenueAmt
CY Total Revenue$75,277,598CYTotalRevenueAmt
PY Grants And Similar Paid$4,358,785PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$49,171CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$30,410,905PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$32,827,328CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$6,683PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$200CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$200CYTotalFundraisingExpenseAmt
PY Other Expenses$30,429,385PYOtherExpensesAmt
CY Other Expenses$34,767,870CYOtherExpensesAmt
PY Total Expenses$65,205,758PYTotalExpensesAmt
CY Total Expenses$67,644,569CYTotalExpensesAmt
PY Revenues Less Expenses$1,923,345PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$7,633,029CYRevenuesLessExpensesAmt
Total Assets BOY$101,611,660TotalAssetsBOYAmt
Total Assets EOY$109,141,859TotalAssetsEOYAmt
Total Liabilities BOY$50,996,653TotalLiabilitiesBOYAmt
Total Liabilities EOY$51,886,313TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$50,615,007NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$57,255,546NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$57,225,969ExpenseAmt
Grant$49,171GrantAmt
Revenue$71,252,664RevenueAmt
DescIN FY 2019, RIVERWOOD COMPLETED A MAJOR EXPANSION AND RENOVATION OF ITS PRIMARY AND SPECIALTY CARE CLINICS IN AITKIN, INCLUDING THE ADDITION OF A KIDNEY DIALYSIS CENTER. THE ORGANIZATION ALSO INTRODUCED ROBOTIC-ASSISTED SURGERY WITH THE DA VINCI XI SYSTEM, WHICH FURTHER EXPANDED SURGEONS' CAPABILITIES FOR PERFORMING MINIMALLY INVASIVE SURGERY FOR RAPID RECOVERY OUTCOMES. HEALTH EDUCATION FOR THE COMMUNITY CONTINUES TO BE A MAJOR FOCUS, INCLUDING SEMINARS ON ORTHOPEDICS AND TOTAL JOINT REPLACEMENT, HERNIA REPAIR, AND REFLUX AND HEARTBURN, PARTICIPATION IN LOCAL HEALTH AND WELLNESS FAIRS AND COMMUNITY WALKS/RUNS AND PARTNERING WITH AITKIN COUNTY HEALTH AND HUMAN SERVICES, LAW ENFORCEMENT AND LOCAL SCHOOL DISTRICTS. RIVERWOOD HEALTHCARE CENTER STRIVES TO DELIVER THE HIGHEST QUALITY PATIENT-CENTERED CARE. WE CONTINUALLY EXAMINE EMERGING HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE THROUGHOUT AITKIN COUNTY AND THE GARRISON AND MILLE LACS AREA. WITH A STRONG FOCUS ON HEALTH, WELLNESS AND PREVENTION, THE CENTER STRIVES TO EDUCATE AND INFORM ITS PATIENTS AND THE COMMUNITY ON HEALTH ISSUES. THE COMMUNITY'S AND PATIENT'S NEEDS ARE LISTENED TO AND INCORPORATED IN OUR MISSION STATEMENT, STRATEGIC PLAN, AND VISION. IN FISCAL YEAR 2019, RIVERWOOD HEALTHCARE CENTER COMPLETED A 2-YEAR BUILDING PROJECT WHICH INCLUDED BOTH AN EXPANSION AND RENOVATION. THE PROJECT, WHICH BROKE GROUND IN JULY 2017 AND PROCEEDED IN FOUR PHASES, INCLUDED RELOCATION AND EXPANSION OF THERAPY SERVICES; A REDESIGN OF THE SPECIALTY CLINIC TO ALLOW FOR EXPANSION OF SERVICES AND ACCESS; RENOVATION OF THE PRIMARY CARE CLINIC TO SUPPORT TEAM-BASED PATIENT CARE; AND RENOVATION OF SPACE FOR A NEW KIDNEY CARE AND DIALYSIS CENTER TO OPEN IN JANUARY 2020 AND BE OPERATED IN PARTNERSHIP WITH CENTRACARE HEALTH. THE REDESIGN OF THE SPECIALTY CLINIC ALLOWS FOR EXPANDED SERVICES LINES IN AITKIN COUNTY AS WELL AS ADDITIONAL IMAGING CAPABILITIES WITH A SPACE THAT IS SPECIFICALLY DESIGNED FOR THE DAVINCI SURGICAL ROBOT. THE NEW DIALYSIS UNIT WILL NOT ONLY PROVIDE CLOSE TO HOME NECESSARY CARE FOR RENAL PATIENTS, BUT ALSO WILL BE OF HELP TO FAMILY MEMBERS AND FRIENDS ON THEIR SUPPORT OF THE PATIENT, SINCE THE NEED TO TRAVEL FAR FROM HOME FOR CARE WILL BE GREATLY REDUCED. IN ADDITION, RENOVATIONS TO RIVERWOOD'S EMERGENCY DEPARTMENT CREATED MORE SPACE FOR PATIENT CARE AND A LARGER, MORE PRIVATE WAITING ROOM FOR FAMILY MEMBERS AND VISITORS. THE BUILDING PROJECT'S TOTAL INVESTMENT WAS APPROXIMATELY $15 MILLION DOLLARS AND RENOVATED 27,915 SQ FEET AND CREATED 19,161 SQ FEET OF NEW PATIENT CARE SPACE. THE ADDITION OF THE DA VINCI ROBOTIC SURGICAL SYSTEM HAS PROVIDED PATIENTS AN OPTION OF MINIMALLY INVASIVE SURGERY WITH RECOVERY TIMES THAT ARE SIGNIFICANTLY DIMINISHED. THIS NEW TECHNOLOGY THAT HAS BEEN IMPLEMENTED AT RIVERWOOD WILL INCREASE OUR COMMUNITY'S ACCESS TO CUTTING EDGE SURGICAL CARE AND WILL ALLOW RIVERWOOD TO EXPAND THE NUMBER OF MINIMALLY INVASIVE SURGERIES OFFERED IN OUR COMMUNITY. THE DA VINCI PLATFORM ALSO ALLOWS FOR SEVERAL DIFFERENT PROCEDURES THAT RIVERWOOD WILL BE ABLE TO PERFORM IN THE FUTURE. RIVERWOOD PLACES CONTINUING EMPHASIS ON WORKING TOWARDS THE GOALS AS DEFINED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT, LAST COMPLETED IN 2019. WITH IDENTIFIED PRIORITY HEALTH ISSUES OF MENTAL HEALTH, ACCESS TO HEALTHCARE SERVICES, NUTRITION, PHYSICAL ACTIVITY, WEIGHT, AND DIABETES, WE KEEP THE NEEDS OF OUR PATIENTS AT THE FOREFRONT OF OUR ENDEAVORS. OUR PROGRESS AND SUCCESSES EACH YEAR ARE DUE TO THE CONTINUAL FOCUS ON ADDRESSING OUR COMMUNITY'S HEALTH CARE NEEDS.Desc
Total Program Service Expenses$57,225,969TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document61IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee477EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JUDY TURNERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2189272121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BUNKER HILL DRIVEAddressLine1Txt
CityAITKINCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56431ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DR JEFF EHNSTROM
DIRECTOR/PHYSICIAN40.00Yes (X)$415,004$0$42,491
CHRISTINE BRIGHT
VICE CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
CHAD GROSS
DIRECTOR1.00Yes (X)$0$0$0
KATHLEEN RYAN
CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
DAVID MEYER
FORMER DIRECTOR1.00Yes (X)$0$0$0
LOWELL LARSON
DIRECTOR1.00Yes (X)$0$0$0
TOM LUNDBERG
DIRECTOR1.00Yes (X)$0$0$0
JARED LUNDGREN
DIRECTOR1.00Yes (X)$0$0$0
MIKE PAULBECK
DIRECTOR1.00Yes (X)$0$0$0
ALISON MATALAMAKI
TREASURER1.00Yes (X)$0$0$0Yes (X)
STEVE WILSON
SECRETARY1.00Yes (X)$0$0$0Yes (X)
DR TIMOTHY DIRKS
DIRECTOR1.00Yes (X)$0$0$0
TODD A SANDBERG
CEO38.00$196,857$0$18,431Yes (X)2.00
CYNTHIA BAKER
COO40.00$205,273$0$40,051Yes (X)
CASEY JOHNSON
CFO38.00$157,947$0$42,664Yes (X)2.00
DR DAVID TAYLOR
CMO40.00$402,437$0$22,819Yes (X)
DR ERIK BOSTROM
PROVIDER40.00$372,601$0$21,750Yes (X)
DR MELISSA HERBRANSON
PROVIDER40.00$268,725$0$45,995Yes (X)
DR DONALD HUGHES
PROVIDER40.00$291,754$0$41,717Yes (X)
DR JIM HARRIS
ER PHYSICAN40.00$396,295$0$42,252Yes (X)
DR AUSTIN KROHN
PROVIDER40.00$258,488$0$42,193Yes (X)
CHAD COOPER
FORMER CEO (OFFICER)38.00$168,138$0$15,6342.00Yes (X)
DR MARK HEGGEM
FORMER CMO (KEY EMPLOYEE)40.00$136,415$0$23,973Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,269,934TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$399,970TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K45IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CUYUNA REGIONAL MEDICAL CENTER
320 E MAIN STCROSBYMN56441MEDICAL/SURGICAL PROF SVCS$3,688,150
LIFE GUARD ANESTHESIA SERVICES INC
29561 395TH PLACEAITKINMN56431ANESTHESIA PROF SVCS$1,255,657
CENTRAL MINNESOTA DIAGNOSTICS INC
150 10TH STMILACAMN56353RADIOLOGY PROF SVCS$1,077,560
PREMIER SURGICAL ASSOCIATES PA
318 E MAIN STCROSBYMN56441MEDICAL PROF SVCS$598,850
ALLINA HEALTH LABORATORY
PO BOX 342 MAIL RTE 20MINNEAPOLISMN55440LABORATORY SERVICES$280,381
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$724,677RelatedOrganizationsAmt
Government Grants$178,883GovernmentGrantsAmt
All Other Contributions$210,832AllOtherContributionsAmt
Total Contributions$1,114,392TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621500$70,511,924$70,511,924
EQUITY IN EARNINGS OF AFFILIATES900099$357,437$357,437
ELECTRONIC HEALTH RECORD INCENTIV621500$170,000$170,000
FieldValueIRS element (for citing)
Total Program Service Revenue$71,039,361TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,198,887TotalRevenueColumnAmt
Exclusion$1,198,887ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,688,593SecuritiesAmt
Other$4,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,241,750SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,446,843SecuritiesAmt
Other$4,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,450,843TotalRevenueColumnAmt
Exclusion$1,450,843ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
OTHER REVENUE900099$213,303$213,303
CAFETERIA900099$152,702$152,702
SISU MEDICAL SOLUTIONS, LLC K-1 A900099$108,110$108,110
FieldValueIRS element (for citing)
Other Revenue Total$474,115OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$75,277,598TotalRevenueColumnAmt
Related Or Exempt Func Income$71,252,664RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$108,110UnrelatedBusinessRevenueAmt
Exclusion$2,802,432ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$44,171TotalAmt
Program Services$44,171ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Program Services$5,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,747,999TotalAmt
Program Services$451,596ProgramServicesAmt
Management And General$1,296,403ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,418,696TotalAmt
Program Services$21,711,696ProgramServicesAmt
Management And General$2,707,000ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$896,849TotalAmt
Program Services$788,925ProgramServicesAmt
Management And General$107,924ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,082,940TotalAmt
Program Services$3,533,870ProgramServicesAmt
Management And General$549,070ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,680,844TotalAmt
Program Services$1,430,523ProgramServicesAmt
Management And General$250,321ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$36,486TotalAmt
Management And General$36,486ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$118,596TotalAmt
Management And General$118,596ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,319TotalAmt
Management And General$2,319ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$200TotalAmt
Fundraising$200FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,112,193TotalAmt
Program Services$9,011,537ProgramServicesAmt
Management And General$1,100,656ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$132,629TotalAmt
Management And General$132,629ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,879,319TotalAmt
Program Services$1,209,203ProgramServicesAmt
Management And General$670,116ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$260,888TotalAmt
Management And General$260,888ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$783,155TotalAmt
Program Services$657,155ProgramServicesAmt
Management And General$126,000ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$95,250TotalAmt
Program Services$74,972ProgramServicesAmt
Management And General$20,278ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$82,514TotalAmt
Program Services$56,286ProgramServicesAmt
Management And General$26,228ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$921,612TotalAmt
Program Services$644,423ProgramServicesAmt
Management And General$277,189ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,356,033TotalAmt
Program Services$2,684,201ProgramServicesAmt
Management And General$671,832ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$283,779TotalAmt
Management And General$283,779ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS$7,317,739$7,317,739
MEDICAL SUPPLIES$4,177,240$4,112,497$64,743
PROVISION FOR UNCOLLECT$1,784,582$1,784,582
REPAIRS & MAINTENANCE$1,620,975$1,423,685$197,290

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,802,561TotalAmt
Program Services$283,908ProgramServicesAmt
Management And General$1,518,653ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$67,644,569TotalAmt
Program Services$57,225,969ProgramServicesAmt
Management And General$10,418,400ManagementAndGeneralAmt
Fundraising$200FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,161,228BOYAmt
EOY$4,235,317EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,761,470BOYAmt
EOY$13,729,409EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,783,567BOYAmt
EOY$2,169,987EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$445,499BOYAmt
EOY$641,986EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$77,953,876LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,689,868LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$28,452,760BOYAmt
EOY$33,264,008EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$39,397,968BOYAmt
EOY$43,002,977EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,609,168BOYAmt
EOY$12,098,175EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$101,611,660BOYAmt
EOY$109,141,859EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,751,787BOYAmt
EOY$12,226,637EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,849,722BOYAmt
EOY$27,683,575EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$12,395,144BOYAmt
EOY$11,976,101EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$50,996,653BOYAmt
EOY$51,886,313EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,738,957BOYAmt
EOY$51,718,270EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,876,050BOYAmt
EOY$5,537,276EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$50,615,007BOYAmt
EOY$57,255,546EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$101,611,660BOYAmt
EOY$109,141,859EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$7,633,029ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$434,167NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts-$111,439DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets-$446,884OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,319OtherActivitiesAmt
Total Lobbying Expenditures$2,319TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationRIVERWOOD HEALTHCARE CENTER PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$558,828BeginningYearBalanceAmt
Contributions$18,132ContributionsAmt
Investment Earnings Or Losses$31,974InvestmentEarningsOrLossesAmt
Grants Or Scholarships$26,932GrantsOrScholarshipsAmt
Other Expenditures$40,000OtherExpendituresAmt
End Year Balance$542,002EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$615,592BeginningYearBalanceAmt
Contributions$25,570ContributionsAmt
Investment Earnings Or Losses$26,166InvestmentEarningsOrLossesAmt
Grants Or Scholarships$18,500GrantsOrScholarshipsAmt
Other Expenditures$90,000OtherExpendituresAmt
End Year Balance$558,828EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$564,552BeginningYearBalanceAmt
Contributions$650ContributionsAmt
Investment Earnings Or Losses$50,390InvestmentEarningsOrLossesAmt
End Year Balance$615,592EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$530,721BeginningYearBalanceAmt
Contributions$10,600ContributionsAmt
Investment Earnings Or Losses$38,231InvestmentEarningsOrLossesAmt
Grants Or Scholarships$15,000GrantsOrScholarshipsAmt
End Year Balance$564,552EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$558,330BeginningYearBalanceAmt
Contributions$75ContributionsAmt
Investment Earnings Or Losses-$22,684InvestmentEarningsOrLossesAmt
Grants Or Scholarships$5,000GrantsOrScholarshipsAmt
End Year Balance$530,721EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.26410BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.49720PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.23870TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,605,898OtherCostOrOtherBasisAmt
Book Value$1,605,898BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,331,235OtherCostOrOtherBasisAmt
Depreciation$18,727,375DepreciationAmt
Book Value$21,603,860BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,459,764OtherCostOrOtherBasisAmt
Depreciation$23,048,155DepreciationAmt
Book Value$6,411,609BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,556,979OtherCostOrOtherBasisAmt
Depreciation$2,914,338DepreciationAmt
Book Value$3,642,641BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$33,264,008TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
ASSETS LIMITED FOR RESERVE ACCOUNTS$688,320
BENEFICIAL INTEREST IN NET ASSETS-HOSPITAL FOUNDATION$5,537,276
INVESTMENT IN CENTRAL MINNESOTA DIAGNOSTICS, INC.$1,118,481
ASSETS LIMITED BY AGREEMENT FOR DEFERRED COMPENSATION$1,613,168
ASSETS LIMITED BY AGREEMENT FOR WORKER'S COMPENSATION$249,192
ASSETS LIMITED BY BOARD FOR FUNDED DEPRECIATION$3,001,415
INVESTMENT IN RIVERWOOD MEDICAL PROPERTIES, LLC-$109,677
FieldValueIRS element (for citing)
Total Book Value Other Assets$12,098,175TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$72,633,336TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$434,167NetUnrealizedGainsInvstAmt
Other Revenue-$2,097,985OtherRevenueAmt
Revenue Not Reported-$2,532,152RevenueNotReportedAmt
Revenue Subtotal$75,165,488RevenueSubtotalAmt
Other Revenues Not Included$112,110OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$112,110RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$75,277,598TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$65,992,797TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$111,439DonatedServicesUseFcltsAmt
Other Expenses Included$21,371OtherExpensesIncludedAmt
Expenses Not Reported$132,810ExpensesNotReportedAmt
Expenses Subtotal$65,859,987ExpensesSubtotalAmt
Other Expenses Not Included$1,784,582OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,784,582ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$67,644,569TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:TO BE USED AND DISTRIBUTED AS A SCHOLARSHIP OR EDUCATIONAL FUND TO AID IN THE EDUCATION AND RECRUITMENT OF HEALTH CARE PROFESSIONALS FOR RIVERWOOD HEALTHCARE CENTER.
PART X, LINE 2:NONPROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED, AND IN CERTAIN OTHER INSTANCES. NONPROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE ORGANIZATION HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2016.
PART XI, LINE 2D - OTHER ADJUSTMENTS:PROVISION FOR UNCOLLECTIBLE ACCOUNTS -1,784,582. INCREASE IN INTEREST IN NET ASSETS - RIVERWOOD FOUNDATION -338,774. RIVERWOOD MEDICAL PROPERTIES, LLC REVENUE 126,000. ELIMINATIONS RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -100,629.
PART XI, LINE 4B - OTHER ADJUSTMENTS:GAIN ON SALE OF EQUIPMENT 4,000. SISU MEDICAL SOLUTIONS, LLC SCHEDULE K-1 ACTIVITY 108,110.
PART XII, LINE 2D - OTHER ADJUSTMENTS:GAIN ON SALE OF EQUIPMENT -4,000. ELIMINATION RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -126,000. RIVERWOOD MEDICAL PROPERTIES, LLC EXPENSES 151,371.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR UNCOLLECTIBLE ACCOUNTS 1,784,582.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other325.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$925,476TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$925,476NetCommunityBenefitExpnsAmt
Total Expense0.01410TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,040,706TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,891,297DirectOffsettingRevenueAmt
Net Community Benefit Expns$149,409NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,966,182TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,891,297DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,074,885NetCommunityBenefitExpnsAmt
Total Expense0.01640TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$625,882TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$625,882NetCommunityBenefitExpnsAmt
Total Expense0.00950TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,440TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,440NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$648,322TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$648,322NetCommunityBenefitExpnsAmt
Total Expense0.00980TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,614,504TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,891,297DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,723,207NetCommunityBenefitExpnsAmt
Total Expense0.02620TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,784,582BadDebtExpenseAmt
Reimbursed By Medicare$22,808,012ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,113,656CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$305,644MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RIVERWOOD HEALTHCARE CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BUNKER HILL DRIVEAddressLine1Txt
CityAITKINCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56431ZIPCd
FieldValueIRS element (for citing)
State License385083StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1AITKIN COMMUNITY HOSPITAL DBA RIVERWOODBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care325.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, PAGE 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, PAGE 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, PAGE 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCAREPART V, SECTION B, LINE 5: RIVERWOOD HEALTHCARE CENTER SOUGHT INPUT FROM KEY INFORMANTS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. IN ORDER TO DO THIS, RIVERWOOD PROVIDED A LIST OF 200 RECOMMENDED PARTICIPANTS TO THE INDEPENDENT VENDOR, PROFESSIONAL RESEARCH CONSULTANTS, INC(PRC). THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS THEY WORK WITH AS WELL AS THE OVERALL COMMUNITY. OF THE INITIAL RECOMMENDED LIST, 92 PEOPLE PARTICIPATED AS COMMUNITY STAKEHOLDERS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT.
AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCAREPART V, SECTION B, LINE 11: THE MISSION OF RIVERWOOD HEALTHCARE CENTER IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. THE IMPLEMENTATION STRATEGY IS DESIGNED TO ADDRESS THE HEALTH CARE NEEDS OF THE PEOPLE IN AITKIN COUNTY AND THEIR UNIQUE CHARACTERISTICS AND HEALTHCARE NEEDS. THE IMPLEMENTATION STRATEGIES ARE BASED ON RIVERWOOD'S CURRENT PROGRAMMING, SURVEY DATA AND COMMUNITY INPUT. RIVERWOOD'S STRATEGIC PLAN IS DEVELOPED BY ITS LEADERSHIP TEAM AND REVIEWED ANNUALLY. THE IMPLEMENTATION STRATEGY ALSO IDENTIFIES HOW EXISTING AND PLANNED RIVERWOOD SERVICES, PARTNERSHIPS AND PROGRAMS WILL BE UTILIZED TO HELP ADDRESS COMMUNITY HEALTH NEEDS.THE IMPLEMENTATION STRATEGY FOR THE HEALTH OF AITKIN COUNTY IS THE HOSPITAL/COMMUNITY PLAN FOR ADDRESSING THE COMMUNITY HEALTH NEEDS. THE IRS DICTATES THE CONTENTS OF AN IMPLEMENTATION STRATEGY AND STATES THAT THE HOSPITAL MUST ADDRESS HOW IT BOTH INTENDS AND DOES NOT INTEND TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. RIVERWOOD'S IMPLEMENTATION STRATEGY IS DESCRIBED IN THIS SECTION OF THE REPORT. WE WILL CONTINUE TO STAY THE COURSE AND FOLLOW OUR STRATEGIC PLAN. WE WILL CREATE THE FUTURE WE SEEK BY FOCUSING ON FIVE CRITICAL STRATEGIC GOALS.1) COMMUNITY: EXPAND OUR COMMUNITY IMPACT TO INCREASE EMPHASIS ON HEALTH BEHAVIORS, SOCIAL/ECONOMIC FACTORS, AND ENHANCED COMMUNITY PARTNERSHIPS.2) PEOPLE: FOSTER A HIGH PERFORMING WORKPLACE3) STEWARDSHIP: ACHIEVE SUSTAINABLE OPERATING MARGIN AND MAINTAIN ADVANTAGEOUS FINANCIAL AND CASH POSITION 4) QUALITY: EVOLVE OUR CLINICAL CARE DELIVERY MODEL AND CULTURE TO ACHIEVE TOP QUALITY KEY AMBULATORY AND INPATIENT MEASURE RESULTS AND HAVE ZERO PREVENTABLE SERIOUS SAFETY EVENTS5) GROWTH: EXPAND AND ENHANCE BOTH OUR PARTNERSHIP AND PATIENT RELATIONSHIPSPRIORITY HEALTH ISSUES RIVERWOOD WILL ADDRESS:IN CONSIDERATION OF THE TOP HEALTH PRIORITIES IDENTIFIED THRU THE CHNA PROCESS, AND TAKING INTO ACCOUNT HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION STATEMENT, GOALS AND STRATEGIC PRIORITIES, IT WAS DETERMINED THAT RIVERWOOD WILL FOCUS ON DEVELOPING AND/OR SUPPORTING THESE STRATEGIES AND INITIATIVES TO IMPROVE:1) MENTAL HEALTH 2) SUBSTANCE ABUSE3) ACCESS TO HEALTHCARE SERVICES4) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT5) DIABETESISSUES THAT WILL NOT BE ADDRESSED INCLUDE CANCER, INJURY AND VIOLENCE, AND FAMILY PLANNING. LIMITED RESOURCES EXCLUDED CANCER AS AN AREA CHOSEN FOR ACTION AT THIS TIME. RIVERWOOD FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE ACCESS TO HEALTH CARE SERVICES WILL ALSO HAVE A POSITIVE IMPACT IN THIS AREA. AS FOR INJURY AND VIOLENCE, RIVERWOOD BELIEVES THAT THIS PRIORITY AREA FALLS WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. AND FAMILY PLANNING WAS EXCLUDED DUE TO OTHER COMMUNITY ORGANIZATIONS HAVING PROGRAMS TO BETTER MEET THE NEED FOR THIS.CONCLUSION:IN ADDITION TO SPECIFIC STRATEGIES AND MISSION DRIVEN PROGRAMS, RIVERWOOD WILL MAINTAIN IT'S HEALTH CARE HOME CERTIFICATION USING A TEAM BASED APPROACH TO ADDRESS SOCIAL DETERMINATES OF HEALTH AND PATIENT NEEDS. EXPANDING THE ROLE OF MENTAL HEALTH RN THRU BEHAVIORAL HEALTH INTEGRATION WILL SUPPORT THE PROVIDER AND PROVIDE CARE COORDINATION FOR PATIENTS TO ASSIST THEM IN CONNECTING WITH APPROPRIATE COMMUNITY RESOURCES. WE ARE EXPLORING OPTIONS FOR OPPORTUNITIES TO FORM A COMMUNITY WIDE TASKFORCE TO INCREASE MENTAL HEALTH AWARENESS. THE GOAL IS REDUCING AVOIDABLE ED ADMISSIONS DUE TO MENTAL HEALTH CONCERNS. THE MULTIDISCIPLINARY CONTROLLED SUBSTANCE CARE TEAM CONTINUES TO PROVIDE OVERSIGHT TO ALL CLINIC LOCATIONS TO HELP INFORM AND EDUCATE COMMUNITY MEMBERS ABOUT SUBSTANCE ABUSE. THIS TEAM COLLABORATES WITH A LARGER PARTNERSHIP OF LOCAL AND REGIONAL HEALTH SYSTEMS, CITY AND COUNTY LAW ENFORCEMENT, AITKIN COUNTY HEALTH AND HUMAN SERVICES, AREA SCHOOL DISTRICTS AND THE MINNESOTA DEPARTMENT OF HEALTH TO TEACH BEST PRACTICES AND EDUCATE COMMUNITY MEMBERS ABOUT SUBSTANCE ABUSE, PREVENTION AND TREATMENT. THE GOAL HERE IS TO REDUCE BOTH INAPPROPRIATE USE OF OPIOIDS BY PATIENTS AND RATES OF OPIOID ADDICTION BY INCREASING COMMUNITY WIDE AWARENESS. FOR THE AREAS OF NUTRITION, ACTIVITY, WEIGHT, AND DIABETES, RIVERWOOD PARTNERS WITH COMMUNITY EDUCATION THRU AITKIN AND MCGREGOR SCHOOLS AND AITKIN COUNTY PUBLIC HEALTH TO ENCOURAGE THE HEALTH AND WELLNESS OF OUR COMMUNITIES. EDUCATION ON PREVENTION AND OFFERING SUPPORT, MANAGEMENT PROGRAMS AND COMMUNITY RESOURCES SUPPORTS THE HEALTH AND WELL-BEING OF OUR POPULATION. THE PROGRAM OF LIVING WELL WITH CHRONIC CONDITIONS IS OFFERED TO RESIDENTS OF AITKIN COUNTY. A COMMUNITY WELLNESS RESOURCE GUIDE IS MAINTAINED BY RIVERWOOD AND IS AVAILABLE TO ALL PATIENTS AND COMMUNITY MEMBERS. RIVERWOOD CONTINUES TO SUPPORT A HEALTHY COMMUNITY BY PARTICIPATING IN HEALTH FAIRS, COMMUNITY WALKS/RUNS, PROMOTING VOLUNTEERISM AND OFFERING FARM2RIVERWOOD MEALS TO STAFF, PATIENTS AND COMMUNITY MEMBERS.RIVERWOOD BUILDS EVALUATIVE MEASURES AND GOALS INTO ALL ITS PROGRAMS AND SERVICES. IN ADDITION, THE CHNA PLAN IS REVIEWED AND REWRITTEN EVERY THREE YEARS. RIVERWOOD'S MANAGEMENT TEAM CONTINUES TO PLAY A LEADERSHIP ROLE IN THE IMPLEMENTATION STRATEGIES AND MONITOR ITS PROGRESS AND ADJUST STRATEGIES AS NEEDED.
AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCAREPART V, SECTION B, LINE 16J: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO IS AVAILABLE TO TALK WITH ANY PATIENT WHO FEELS THEY MAY HAVE DIFFICULTY PAYING THEIR BILL. SHE IS A TRAINED MNSURE NAVIGATOR AND CAN ASSIST ANYONE WITH CHECKING TO SEE IF THEY QUALIFY FOR MEDICAL ASSISTANCE, MNCARE OR IF THEY COULD PURCHASE AN INSURANCE. SHE OFFERS INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) AND CAN ANSWER ANY QUESTIONS ON APPLYING FOR AND GETTING COMMUNITY CARE THROUGH THE HOSPITAL. ALL THE HOSPITAL'S PATIENT ACCOUNTS REPRESENTATIVES ARE EDUCATED ABOUT COMMUNITY CARE AND IF PATIENTS INDICATE THEY DON'T FEEL THEY CAN PAY, STAFF WILL GET THEM THE FAP AND APPLICATION. NURSING, PHYSICIANS AND ALL PATIENT CARE STAFF ARE EDUCATED ABOUT FAP AND SHARE WITH PATIENTS WHO INDICATED A NEED. RIVERWOOD ALSO HAS DAILY PATIENT CENTERED BEDSIDE ROUNDING WHERE ALL INPATIENTS AND THEIR FAMILIES GET TO MEET WITH THE HOSPITAL'S HEALTHCARE TEAM, WHICH INCLUDES THE FINANCIAL COUNSELOR. EVERY TEAM MEMBER INTRODUCES THEMSELVES AND EXPLAINS WHAT THEY DO, WITH THE FINANCIAL COUNSELOR INFORMING THE PATIENT ABOUT HER AVAILABILITY TO ASSIST THEM WITH ANY OF THEIR INSURANCE OR FINANCIAL NEEDS. EACH INPATIENT ALSO ETS A FOLDER OF BROCHURES OF HEALTHCARE INFORMATION AS PART OF THEIR STAY. THIS FOLDER CONTAINS INFORMATION REGARDING THE FAP AND LISTS THE FINANCIAL COUNSELORS CONTACT INFORMATION, SHOULD A PATIENT WANT TO MAKECONTACT AFTER DISCHARGE FROM THE FACILITY.
PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITEHTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2020/02/2019-CHNA-REPORT_AITKIN-COUNTY-MN.PDF
PART V, LINE 16A, FAP WEBSITEHTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/
PART V, LINE 16B, FAP APPLICATION WEBSITEHTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARYHTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - RIVERWOOD AITKIN CLINIC
200 BUNKER HILL DRIVEAITKINMN56431CLINIC
2 - RIVERWOOD MCGREGOR CLINIC
2 E CENTRAL AVENUEAITKINMN56431CLINIC
3 - RIVERWOOD GARRISON CLINIC
27278 STATE HWY 18GARRISONMN56450CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:IN ADDITION TO INCOME BASED TESTING, OUR CHARITY CARE POLICY REQUIRES THAT AN APPLICANT MUST HAVE RECEIVED A DENIAL FROM EITHER MEDICAID (MINNESOTA ASSISTANCE) OR OTHER STATE SUBSIDIZED HEALTHCARE PROGRAMS (MINNESOTA CARE OR GMAC).
PART I, LINE 7:COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED 2019 MEDICARE COST REPORT.
PART I, LN 7 COL(F):BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS $1,784,582.
PART I LINE 6ATHE ORGANIZATION FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH MINNESOTA. THIS INFORMATION IS AVAILABLE ON THE MINNESOTA HOSPITAL ASSOCIATION WEBSITE.
PART II, COMMUNITY BUILDING ACTIVITIES:N/A
PART III, LINE 2:TO DETERMINE BAD DEBT EXPENSE, RIVERWOOD FILTERS THE ACCOUNTS RECEIVABLE DETAIL MONTHLY BY SELF-PAY. THOSE SELF-PAY BALANCES THEN GET PLACED INTO BUCKETS BASED ON THEIR SERVICE DATE. RIVERWOOD THEN APPLIES AN INCREASINGLY LARGER PERCENTAGE BASED ON THE AGING OF THE SELF-PAY BALANCE; THE OLDER THE BALANCE IS, THE MORE GETS ALLOWED FOR AND BECOMES BAD DEBT EXPENSE. SEE THE GRADUATED BUCKET %'S BELOW: 0-60: 10%, 61-90: 15%, 91-120: 30%, 121-150: 40%, 151-360: 60%, 361+: 90%
PART III, LINE 3:AT RIVERWOOD HEALTHCARE CENTER, BAD DEBT IS CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE THE INABILITY TO PAY.
PART III, LINE 4:FROM FOOTNOTE 1 OF THE AUDITED FINANCIAL STATEMENTS - "ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE VALUE. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ONGOING ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE (INCLUDING COPAYMENT AND DEDUCTIBLE AMOUNTS FROM PATIENTS), THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH PRIVATE-PAY PATIENTS, THE CENTER RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.THE CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE REVISED AS NEEDED IN FUTURE PERIODS. THE CENTER HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEAR 2019. THE CENTER DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS.RECEIVABLES OR PAYABLES RELATED TO ESTIMATED SETTLEMENTS WITH GOVERNMENT PAYORS ARE REPORTED AS THIRD-PARTY PAYOR SETTLEMENTS RECEIVABLE OR PAYABLE."
PART III, LINE 8:THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6.
PART III, LINE 9B:AITKIN COMMUNITY HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED RATES TO RESIDENTS OF THE COMMUNITY, PRIMARILY TO THE UNINSURED AND TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE UNABLE DUE TO SOCIO-ECONOMIC FACTORS. THE HOSPITAL EMPLOYS A FULL TIME FINANCIAL COUNSELOR WHO WORKS WITH PATIENTS TO EVALUATE ELIGIBILITY AND REDIRECT THEM AS NEEDED TO LOCAL STATE OR COUNTY STAFF FOR ASSISTANCE WITH APPLICATIONS FOR GOVERNMENTAL ASSISTANCE PROGRAMS. UPON RECEIPT OF DENIAL, PATIENT WILL BE PROVIDED A CHARITY CARE APPLICATION. DEPENDING ON THE PATIENT'S INCOME AND THE GUIDELINES, THEY WILL BE PROVIDED A WAIVER OF ALL CHARGES OR A REDUCTION IN THEIR MEDICAL CHARGES. THE HOSPITAL'S BILLING STAFF, PATIENT ACCESS STAFF AND OUTSIDE COLLECTION AGENCIES ARE ALL EDUCATED AND AWARE OF THE CHARITY CARE ASSISTANCE PROGRAM AND IN THE COURSE OF THEIR EVERYDAY WORK WILL OFFER PATIENTS THIS INFORMATION IF THEY EXPRESS A NEED FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:NEEDS ASSESSMENT:AITKIN COMMUNITY HOSPITAL PERFORMS A COMMUNITY NEEDS ASSESSMENT TO EVALUATE THE HEALTH CARE NEEDS OF THE COMMUNITY EVERY 3 YEARS WITH AN OUTSIDE CONSULTING FIRM.
PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:AITKIN COMMUNITY HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED RATES TO RESIDENTS OF THE COMMUNITY, PRIMARILY TO THE UNINSURED AND TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE UNABLE DUE TO SOCIO-ECONOMIC FACTORS. THE HOSPITAL EMPLOYS A FULL TIME FINANCIAL COUNSELOR WHO WORKS WITH PATIENTS TO EVALUATE ELIGIBILITY AND REDIRECT THEM AS NEEDED TO LOCAL STATE OR COUNTY STAFF FOR ASSISTANCE WITH APPLICATIONS FOR GOVERNMENTAL ASSISTANCE PROGRAMS. UPON RECEIPT OF DENIAL, PATIENT WILL BE PROVIDED A CHARITY CARE APPLICATION. DEPENDING ON THE PATIENT'S INCOME AND THE GUIDELINES, THEY WILL BE PROVIDED A WAIVER OF ALL CHARGES OR A REDUCTION IN THEIR MEDICAL CHARGES. RIVERWOOD'S EMPLOYED FINANCIAL COUNSELOR IS A MNSURE NAVIGATOR, TRAINED AND CERTIFIED BY THE STATE OF MINNESOTA, AND IS AVAILABLE TO ASSIST PATIENTS WITH CHECKING FOR THEIR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE, MNSURE, OR TO PURCHASE INSURANCE.THE HOSPITAL'S BILLING STAFF, PATIENT ACCESS STAFF AND OUTSIDE COLLECTION AGENCIES ARE ALL EDUCATED AND AWARE OF THE CHARITY CARE ASSISTANCE PROGRAM AND IN THE COURSE OF THEIR EVERYDAY WORK WILL OFFER PATIENTS THIS INFORMATION IF THEY EXPRESS A NEED FOR FINANCIAL ASSISTANCE. NURSING PROVIDERS AND ALL HEALTHCARE STAFF ARE ALSO AWARE OF THE ASSISTANCE PROGRAM AND CAN HELP DIRECT PATIENTS TO THE FINANCIAL COUNSELOR.
PART VI, LINE 4:COMMUNITY INFORMATION:AITKIN COMMUNITY HOSPITAL, INC. DBA RIVERWOOD HEATLHCARE CENTER (RIVERWOOD), A 501(C)3 NON-PROFIT CORPORATION, IS SITUATED IN THE CENTER OF AITKIN COUNTY. IT WAS FOUNDED IN 1948 AND IS LOCATED AT 200 BUNKER HILL DRIVE IN AITKIN, MN (POP. 1984). RIVERWOOD IS A 25 BED ACUTE-CARE CRITICAL ACCESS HOSPITAL AND HAS THREE RURAL HEALTH CLINICS IN AITKIN, MCGREGOR, AND GARRISON. ALL THREE CLINICS ARE LOCATED IN A MEDICALLY UNDERSERVED AREA (MUA). RIVERWOOD OFFERS PATIENTS A CONTINUUM OF CARE INCLUDING INPATIENT, OUTPATIENT, SPECIALTY, SURGICAL AND EMERGENCY SERVICES. THE DISTANCE TO THE NEXT HOSPITAL IS 17 MILES. DULUTH AND ST. CLOUD ARE THE TWO CLOSEST CITIES WITH TERTIARY CARE CENTERS BOTH APPROXIMATELY 90 MILES FROM AITKIN. RIVERWOOD SERVES THE RESIDENTS OF AITKIN COUNTY (POP. 15.834), THE EAST SIDE OF CROW WING COUNTY (POP. 63,855) AND MILLE LACS COUNTY (POP. 25,728). THE GEOGRAPHIC AREA OF THESE COUNTIES IS RURAL. SPECIAL POPULATIONS SERVED INCLUDE THOSE WITH A HIGH RATE OF POVERTY AND UNEMPLOYMENT WITHIN AITKIN, CROW WING AND MILLE LACS COUNTIES. IN 2018, THE ESTIMATED PERCENTAGES OF THESE THREE COUNTIES WITH POPULATIONS BELOW POVERTY LEVEL WERE RESPECTIVELY: AITKIN - 13.5%, CROW WING - 12.7%, MILLE LACS - 12.3%. OTHER SPECIAL POPULATIONS SERVED ALSO INCLUDE THE ELDERLY. THE LARGEST PERCENTAGE OF RIVERWOOD'S CURRENT PATIENT BASE CONSISTS OF PATIENTS OVER THE AGE OF 65, REPRESENTING 32% OF THE POPULATION. AITKIN COUNTY HAS THE OLDEST MEDIAN POPULATION IN THE STATE OF MINNESOTA.
PART VI, LINE 5:PROMOTION OF COMMUNITY HEALTH: IN FURTHERANCE OF ITS CHARITABLE PUPOSE, THE CENTER PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY BASED SERVICE PROGRAMS AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITONALLY, A LARGE NUMBER OF HEALTH RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS AND PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. RIVERWOOD REGULARLY PARTNERS WITH AITKIN COUNTY HEALTH AND HUMAN SERVICES, CITY AND COUNTY LAW ENFORCMENT, AREA SCHOOL DISTRICTS AND OTHER HEALTH CARE PROVIDERS TO EDUCATE, PLAN AND COLLABORATE ON HEALTHCARE NEEDS OF THE COMMUNITY.
PART VI, LINE 6:AFFILIATED HEALTH CARE SYSTEM:N/A
PART VI, LINE 7, REPORTS FILED WITH STATESMN

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1RIVERWOOD HEALTHCARE CENTER & COMMUNITY HOSPITAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BUNKER HILLAddressLine1Txt
CityAITKINCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56431ZIPCd
FieldValueIRS element (for citing)
Recipient EIN411738787RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Non Cash Assistance$36,737NonCashAssistanceAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Non Cash AssistanceADMINISTRATIVE EXPENSESNonCashAssistanceDesc
Purpose Of GrantTO PROVIDE ADMINISTRATIVE SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL PAYS FOR CERTAIN ADMINISTRATIVE EXPENSES FOR THE FOUNDATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR JEFF EHNSTROM
DIRECTOR/PHYSICIAN$407,459$0$7,500$0$45$0$11,000$0$31,491$0$457,495$0$0$0
TODD A SANDBERG
CEO$171,834$0$25,000$0$23$0$3,073$0$15,358$0$215,288$0$0$0
CYNTHIA BAKER
COO$191,958$0$13,270$0$45$0$8,594$0$31,457$0$245,324$0$0$0
CASEY JOHNSON
CFO$149,632$0$8,270$0$45$0$6,881$0$35,783$0$200,611$0$0$0
DR DAVID TAYLOR
CMO$397,892$0$4,500$0$45$0$11,000$0$11,819$0$425,256$0$0$0
DR ERIK BOSTROM
PROVIDER$362,556$0$10,000$0$45$0$11,000$0$10,750$0$394,351$0$0$0
DR MELISSA HERBRANSON
PROVIDER$258,680$0$10,000$0$45$0$11,000$0$34,995$0$314,720$0$0$0
DR DONALD HUGHES
PROVIDER$281,709$0$10,000$0$45$0$11,000$0$30,717$0$333,471$0$0$0
DR JIM HARRIS
ER PHYSICAN$391,750$0$4,500$0$45$0$11,000$0$31,252$0$438,547$0$0$0
DR AUSTIN KROHN
PROVIDER$248,443$0$10,000$0$45$0$10,724$0$31,469$0$300,681$0$0$0
CHAD COOPER
FORMER CEO (OFFICER)$110,605$0$57,518$0$15$0$6,621$0$9,013$0$183,772$0$0$0
DR MARK HEGGEM
FORMER CMO (KEY EMPLOYEE)$128,119$0$8,270$0$26$0$5,667$0$18,306$0$160,388$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF AITKIN
A4160049182016-05-17$5,985,025REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001000
CITY OF MCGREGOR
B4109067362016-05-17$8,000,000REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001000
CITY OF TAMARACK
C4113158422016-05-17$8,000,000REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001000
CITY OF AITKIN
D4160049182017-12-28$9,732,000RENOVATE, EXPAND, & EQUIP CLINIC SPACE; BUILD 9 CHAIR KIDNEY DIALYSIS CENTER000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$983,208$5,985,025$89,142$5,895,8832013Yes (1)0Yes (1)Yes (1)
B$1,314,224$8,000,000$119,153$7,880,8472013Yes (1)0Yes (1)Yes (1)
C$1,314,224$8,000,000$119,153$7,880,8472013Yes (1)0Yes (1)Yes (1)
D$83,675$9,732,000$194,640$9,537,360201900Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B00000.000000.000000.0000000Yes (1)
C00000.000000.000000.0000000Yes (1)
D00000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)0Yes (1)000Yes (1)
B00Yes (1)0Yes (1)000Yes (1)
C00Yes (1)0Yes (1)000Yes (1)
D00Yes (1)0Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJENNIFER EHNSTROMPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY MEMBER OF BOARD MEMBER JEFFREY EHNSTROM, MDRelationshipDescriptionTxt
Transaction$19,386TransactionAmt
TransactionEMPLOYMENTTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6RIVERWOOD HEALTHCARE CENTER HAS MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7ARIVERWOOD HEALTHCARE CENTER HAS MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD HAS AUTHORIZED THE FINANCE COMMITTEE TO REVIEW AND APPROVE THE 990 AFTER PREPARATION. AFTER APPROVAL BY THE FINANCE COMMITTEE, THE 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. CONFLICTS ARE DISCUSSED, REVIEWED, AND FORMS ARE SIGNED ANNUALLY BY EACH BOARD MEMBER. THIS IS DONE AT THE HOSPITAL'S ANNUAL REORGANIZATIONAL MEETING. SECTION 1. PURPOSE THE PURPOSE OF THIS POLICY IS TO PROVIDE A MEANS BY WHICH TO ADDRESS ANY CONFLICT OF INTEREST INVOLVING THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, AND EMPLOYEES THAT AFFECT OR HAVE THE POTENTIAL TO AFFECT THE SAFETY OR QUALITY OF CARE, TREATMENT, AND SERVICES. SECTION 2. PERSONS CONCERNED THIS STATEMENT IS DIRECTED NOT ONLY TO BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, BUT TO ALL EMPLOYEES OR NON-EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF RHCC. FOR EXAMPLE, THIS WOULD INCLUDE ALL WHO MAKE PURCHASING DECISIONS, ALL PERSONS WHO MIGHT BE DESCRIBED AS "MANAGEMENT PERSONNEL, AND ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING RHCC. SECTION 3. AREAS IN WHICH CONFLICT MAY ARISE CONFLICTS OF INTEREST MAY ARISE IN THE RELATIONS OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WITH ANY OF THE FOLLOWING THIRD PARTIES: 1. PERSONS AND FIRMS SUPPLYING GOODS AND SERVICES TO RHCC. 2. PERSONS AND FIRMS FROM WHOM RHCC LEASES PROPERTY AND EQUIPMENT. 3. PERSONS AND FIRMS WITH WHOM RHCC IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES, OR OTHER PROPERTY. 4. COMPETING OR AFFINITY ORGANIZATIONS. 5. DONORS AND OTHERS SUPPORTING RHCC. 6. AGENCIES, ORGANIZATIONS AND ASSOCIATIONS WHICH AFFECT THE OPERATIONS OF RHCC. 7. FAMILY MEMBERS, FRIENDS, AND OTHER EMPLOYEES. SECTION 4. NATURE OF CONFLICTING INTEREST A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS MENTIONED IN SECTION 3. SUCH AN INTEREST MIGHT ARISE THROUGH: SECTION 5. INTERPRETATION OF THIS STATEMENT OF POLICY THE AREAS OF CONFLICTING INTEREST LISTED IN SECTION 3, AND THE RELATIONS IN THOSE AREAS WHICH MAY GIVE RISE TO CONFLICT, AS LISTED IN SECTION 4, ARE NOT EXHAUSTIVE. CONFLICTS MIGHT ARISE IN OTHER AREAS OR THROUGH OTHER RELATIONS. IT IS ASSUMED THAT THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WILL RECOGNIZE SUCH AREAS AND RELATION BY ANALOGY. THE FACT THAT ONE OF THE INTERESTS DESCRIBED IN SECTION 4 EXISTS DOES NOT NECESSARILY MEAN THAT A CONFLICT EXISTS, OR THAT THE CONFLICT, IF IT EXISTS, IS MATERIAL ENOUGH TO BE OF PRACTICAL IMPORTANCE, OR IF MATERIAL, THAT UPON FULL DISCLOSURE OF ALL RELEVANT FACTS AND CIRCUMSTANCES IT IS NECESSARILY ADVERSE TO THE INTERESTS OF RHCC. HOWEVER, IT IS THE POLICY OF THE GOVERNING BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS DESCRIBED IN SECTION 4 SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. SECTION 6. DISCLOSURE POLICY AND PROCEDURE PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST AND ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE GOVERNING BOARD OF DIRECTORS OR TO A COMMITTEE WITH BOARD-DELEGATED POWERS; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL BE EXCLUDED FROM THE DISCUSSION AND VOTE ON APPROVAL OF SUCH TRANSACTION; 3. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 4. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER RHCC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST; 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN RHCC'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO RHCC, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. DISCLOSURE DISCLOSURE IN RHCC SHOULD BE MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE GOVERNING BOARD OF DIRECTORS. DISCLOSURE INVOLVING DIRECTORS SHOULD BE MADE TO THE GOVERNING BOARD CHAIR (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE GOVERNING BOARD VICE-CHAIR) WHO SHALL BRING THESE MATTERS TO THE GOVERNING BOARD. DECISION THE GOVERNING BOARD OF DIRECTORS OR A COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO RHCC. IN THE CASE OF A CONFLICT INVOLVING A MEMBER OF THE GOVERNING BOARD OF DIRECTORS, THE GOVERNING BOARD OR COMMITTEE REVIEWING THE MATTER SHALL CONSIDER THE DISABLING GUIDELINES ATTACHED HERETO. THE DECISION OF THE GOVERNING BOARD OR COMMITTEE ON THESE MATTERS WILL REST IN ITS SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF RHCC AND THE ADVANCEMENT OF RHCC'S PURPOSE. SECTION 7. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY 1. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. 2. IF, AFTER HEARING THE RESPONSE OF THE PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE NO ACTION, REPRIMAND, REQUEST FOR RESIGNATION OR REMOVAL FROM THE BOARD OF DIRECTORS AS THE FACTS AND CIRCUMSTANCES MAY WARRANT. SECTION 9. COMPENSATION 1. A VOTING MEMBER OF THE BOARD OF DIRECTORS WHO RECEIVES COMPENSATION FOR PROVISION OF SERVICES AS AN EMPLOYEE OR CONTRACTOR, DIRECTLY OR INDIRECTLY, FROM RHCC IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 2. A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 3. NO MEMBER OF THE BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. 4. PHYSICIANS WHO RECEIVE COMPENSATION FROM RHCC, WHETHER DIRECTLY OR INDIRECTLY OR AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS. NO PHYSICIAN, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING PHYSICIAN COMPENSATION. SECTION 10. ANNUAL STATEMENTS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING OR FOUNDATION BOARD DELEGATED POWERS, AND ALL LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON-- 1. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2. HAS READ AND UNDERSTANDS THE POLICY; 3. HAS AGREED TO COMPLY WITH THE POLICY; AND 4. UNDERSTANDS THAT RHCC IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15ARIVERWOOD HAS A COMPENSATION COMMITTEE OF THE BOARD WHICH MEETS ANNUALLY TO REVIEW, DISCUSS AND RECOMMEND APPROVAL TO THE FULL BOARD OF THE ANNUAL INCENTIVE COMPENSATION GOALS FOR THE CEO AND CERTAIN MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM. ANNUALLY, THE COMMITTEE ALSO REVIEWS COMPENSATION OF THE CEO AS WELL AS MEMBERS OF THE EXECUTIVE LEADERSHIP TO ENSURE STATED COMPENSATION FALLS WITHIN A FAIR MARKET VALUE RANGE. IN DOING SO, THE COMMITTEE RELIES HEAVILY ON A COMPENSATION SURVEY(S) WHICH IS CONDUCTED BY AN EXTERNAL COMPENSATION CONSULTANT GENERALLY EVERY 2 YEARS, ALONG WITH ANY OTHER DATA OR FACTORS WHICH THE COMMITTEE MAY DEEM RELEVANT FROM TIME TO TIME. UPON RECOMMENDATION FROM THE COMPENSATION COMMITTEE, THE FULL BOARD IS RESPONSIBLE FOR APPROVING COMPENSATION OF THE CEO AS WELL AS THE ANNUAL INCENTIVE COMPENSATION GOALS AND ASSOCIATED METRICS. DOCUMENTATION AND RECORD KEEPING IS MAINTAINED FOR BOTH COMPENSATION COMMITTEE AND BOARD MEETINGS WHERE COMPENSATION DISCUSSIONS AND/OR DECISIONS OCCUR. THE FULL PROCESS AS SUMMARIZED ABOVE LAST OCCURRED IN THE FALL OF 2018.
FORM 990, PART VI, SECTION C, LINE 19RIVERWOOD ANNUALLY PRODUCES A FISCAL YEAR-END FINANCIALS REPORT SHOWING THE ORGANIZATION'S FINANCIAL STATUS VIA A STATEMENT OF OPERATIONS, STATISTICAL HIGHLIGHTS AND COMMUNITY BENEFITS STATEMENT. THIS REPORT IS MADE AVAILABLE TO THE PUBLIC FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IT IS DISTRIBUTED TO MEMBERS OF THE ORGANIZATION AT AN ANNUAL MEETING AND IS POSTED TO OUR WEBSITE IN THE ABOUT US SECTION. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11GPHYSICIAN FEES: PROGRAM SERVICE EXPENSES 3,795,906. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,795,906. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,215,631. MANAGEMENT AND GENERAL EXPENSES 1,100,656. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,316,287.
FORM 990, PART XI, LINE 9:INCREASE IN INTEREST IN NET ASSETS OF RIVERWOOD FOUNDATION -338,774. SISU MEDICAL SOLUTIONS, LLC SCHEDULE K-1 ACTIVITY -108,110.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
RIVERWOOD HEALTH CARE CENTER FOUNDATION
200 BUNKER HILL DRIVEAITKINMN56431411738787SUPPORTMN501(C)(3)LINE 12A, IRIVERWOOD HEALTHCARE CENTERYes (1)
RIVERWOOD MEDICAL PROPERTIES LLC
200 BUNKER HILL DRIVEAITKINMN56431823113322SUPPORTMN501(C)(3)LINE 7RIVERWOOD HEALTHCARE CENTERYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
RIVERWOOD FOUNDATION
C$640,371FMV
RIVERWOOD FOUNDATION
R$80,223FMV
RIVERWOOD MEDICAL PROPERTIES
C$84,306FMV
RIVERWOOD MEDICAL PROPERTIES
K$126,000FMV

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