2020-08-10T09:23:38-05:00 2019-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 558021926 990 2018-10-01 410745522 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER AITK 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 CASEY JOHNSON CFO 2189272121 2020-08-07 1 JULIE BOYER P01278549 2187275025 2020-08-07 67.3.59.197 2020-08-07 08:36:01 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A3EA2213F362026AE26E78146383F0EC02CC4472 2018 2020-09-23 17:36:50Z TODD SANDBERG 200 BUNKER HILL DRIVE AITKIN MN 56431 78519348 0 X WWW.RIVERWOODHEALTHCARE.COM X 1948 MN INPATIENT AND OUTPATIENT MEDICAL CARE AND THREE PRIMARY CARE CLINICS. 11 10 477 100 108110 0 416723 1114392 64335185 71039361 2022627 2649730 354568 474115 67129103 75277598 4358785 49171 0 0 30410905 32827328 6683 200 200 30429385 34767870 65205758 67644569 1923345 7633029 101611660 109141859 50996653 51886313 50615007 57255546 X TO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 0 0 57225969 49171 71252664 IN 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. 57225969 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 61 0 1 477 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 MN X JUDY TURNER 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 DR JEFF EHNSTROM DIRECTOR/PHYSICIAN 40.00 X 415004 0 42491 CHRISTINE BRIGHT VICE CHAIRMAN 1.00 X X 0 0 0 CHAD GROSS DIRECTOR 1.00 X 0 0 0 KATHLEEN RYAN CHAIRMAN 1.00 X X 0 0 0 DAVID MEYER FORMER DIRECTOR 1.00 X 0 0 0 LOWELL LARSON DIRECTOR 1.00 X 0 0 0 TOM LUNDBERG DIRECTOR 1.00 X 0 0 0 JARED LUNDGREN DIRECTOR 1.00 X 0 0 0 MIKE PAULBECK DIRECTOR 1.00 X 0 0 0 ALISON MATALAMAKI TREASURER 1.00 X X 0 0 0 STEVE WILSON SECRETARY 1.00 X X 0 0 0 DR TIMOTHY DIRKS DIRECTOR 1.00 X 0 0 0 TODD A SANDBERG CEO 38.00 2.00 X 196857 0 18431 CYNTHIA BAKER COO 40.00 X 205273 0 40051 CASEY JOHNSON CFO 38.00 2.00 X 157947 0 42664 DR DAVID TAYLOR CMO 40.00 X 402437 0 22819 DR ERIK BOSTROM PROVIDER 40.00 X 372601 0 21750 DR MELISSA HERBRANSON PROVIDER 40.00 X 268725 0 45995 DR DONALD HUGHES PROVIDER 40.00 X 291754 0 41717 DR JIM HARRIS ER PHYSICAN 40.00 X 396295 0 42252 DR AUSTIN KROHN PROVIDER 40.00 X 258488 0 42193 CHAD COOPER FORMER CEO (OFFICER) 38.00 2.00 X 168138 0 15634 DR MARK HEGGEM FORMER CMO (KEY EMPLOYEE) 40.00 X 136415 0 23973 3269934 0 399970 45 1 1 0 CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN ST CROSBY MN 56441 MEDICAL/SURGICAL PROF SVCS 3688150 LIFE GUARD ANESTHESIA SERVICES INC 29561 395TH PLACE AITKIN MN 56431 ANESTHESIA PROF SVCS 1255657 CENTRAL MINNESOTA DIAGNOSTICS INC 150 10TH ST MILACA MN 56353 RADIOLOGY PROF SVCS 1077560 PREMIER SURGICAL ASSOCIATES PA 318 E MAIN ST CROSBY MN 56441 MEDICAL PROF SVCS 598850 ALLINA HEALTH LABORATORY PO BOX 342 MAIL RTE 20 MINNEAPOLIS MN 55440 LABORATORY SERVICES 280381 6 724677 178883 210832 1114392 NET PATIENT SERVICE REVENUE 621500 70511924 70511924 EQUITY IN EARNINGS OF AFFILIATES 900099 357437 357437 ELECTRONIC HEALTH RECORD INCENTIV 621500 170000 170000 71039361 1198887 1198887 4688593 4000 3241750 0 1446843 4000 1450843 1450843 OTHER REVENUE 900099 213303 213303 CAFETERIA 900099 152702 152702 SISU MEDICAL SOLUTIONS, LLC K-1 A 900099 108110 108110 474115 75277598 71252664 108110 2802432 X 44171 44171 5000 5000 1747999 451596 1296403 24418696 21711696 2707000 896849 788925 107924 4082940 3533870 549070 1680844 1430523 250321 36486 36486 118596 118596 2319 2319 200 200 10112193 9011537 1100656 132629 132629 1879319 1209203 670116 260888 260888 783155 657155 126000 95250 74972 20278 82514 56286 26228 921612 644423 277189 3356033 2684201 671832 283779 283779 DRUGS 7317739 7317739 MEDICAL SUPPLIES 4177240 4112497 64743 PROVISION FOR UNCOLLECT 1784582 1784582 REPAIRS & MAINTENANCE 1620975 1423685 197290 1802561 283908 1518653 67644569 57225969 10418400 200 5161228 4235317 11761470 13729409 1783567 2169987 445499 641986 77953876 44689868 28452760 33264008 39397968 43002977 14609168 12098175 101611660 109141859 9751787 12226637 28849722 27683575 12395144 11976101 50996653 51886313 X 44738957 51718270 5876050 5537276 50615007 57255546 101611660 109141859 X 7633029 -434167 -111439 -446884 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2319 2319 0 PART II-B, LINE 1: RIVERWOOD 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. 558828 18132 31974 26932 40000 542002 615592 25570 26166 18500 90000 558828 564552 650 50390 615592 530721 10600 38231 15000 564552 558330 75 -22684 5000 530721 0.26410 0.49720 0.23870 0 1 1 1605898 1605898 40331235 18727375 21603860 29459764 23048155 6411609 6556979 2914338 3642641 33264008 ASSETS LIMITED FOR RESERVE ACCOUNTS 688320 BENEFICIAL INTEREST IN NET ASSETS-HOSPITAL FOUNDATION 5537276 INVESTMENT IN CENTRAL MINNESOTA DIAGNOSTICS, INC. 1118481 ASSETS LIMITED BY AGREEMENT FOR DEFERRED COMPENSATION 1613168 ASSETS LIMITED BY AGREEMENT FOR WORKER'S COMPENSATION 249192 ASSETS LIMITED BY BOARD FOR FUNDED DEPRECIATION 3001415 INVESTMENT IN RIVERWOOD MEDICAL PROPERTIES, LLC -109677 12098175 X 72633336 -434167 -2097985 -2532152 75165488 112110 112110 75277598 65992797 111439 21371 132810 65859987 1784582 1784582 67644569 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. 1 1 X 1 X 1 X 325.000000000000 1 1 0 1 1 925476 925476 0.01410 11040706 10891297 149409 0.00230 11966182 10891297 1074885 0.01640 625882 625882 0.00950 22440 22440 0.00030 648322 648322 0.00980 12614504 10891297 1723207 0.02620 1 1784582 22808012 23113656 -305644 X 1 1 1 1 RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN MN 56431 385083 X X X X AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V, PAGE 8 X 1 18 0 1 0 1 X 150.000000000000 325.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X 1 X 0 0 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART 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 HEALTHCARE PART 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 HEALTHCARE PART 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 WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2020/02/2019-CHNA-REPORT_AITKIN-COUNTY-MN.PDF PART V, LINE 16A, FAP WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/ PART V, LINE 16B, FAP APPLICATION WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/ PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY HTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE/ 3 1 - RIVERWOOD AITKIN CLINIC 200 BUNKER HILL DRIVE AITKIN MN 56431 CLINIC 2 - RIVERWOOD MCGREGOR CLINIC 2 E CENTRAL AVENUE AITKIN MN 56431 CLINIC 3 - RIVERWOOD GARRISON CLINIC 27278 STATE HWY 18 GARRISON MN 56450 CLINIC 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 6A THE 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 STATES MN 0 RIVERWOOD HEALTHCARE CENTER & COMMUNITY HOSPITAL FOUNDATION 200 BUNKER HILL AITKIN MN 56431 411738787 501(C)(3) 36737 FMV ADMINISTRATIVE EXPENSES TO PROVIDE ADMINISTRATIVE SUPPORT 1 PART I, LINE 2: THE HOSPITAL PAYS FOR CERTAIN ADMINISTRATIVE EXPENSES FOR THE FOUNDATION. X X X X X X 0 0 0 0 0 0 0 0 0 DR JEFF EHNSTROM DIRECTOR/PHYSICIAN 407459 0 7500 0 45 0 11000 0 31491 0 457495 0 0 0 TODD A SANDBERG CEO 171834 0 25000 0 23 0 3073 0 15358 0 215288 0 0 0 CYNTHIA BAKER COO 191958 0 13270 0 45 0 8594 0 31457 0 245324 0 0 0 CASEY JOHNSON CFO 149632 0 8270 0 45 0 6881 0 35783 0 200611 0 0 0 DR DAVID TAYLOR CMO 397892 0 4500 0 45 0 11000 0 11819 0 425256 0 0 0 DR ERIK BOSTROM PROVIDER 362556 0 10000 0 45 0 11000 0 10750 0 394351 0 0 0 DR MELISSA HERBRANSON PROVIDER 258680 0 10000 0 45 0 11000 0 34995 0 314720 0 0 0 DR DONALD HUGHES PROVIDER 281709 0 10000 0 45 0 11000 0 30717 0 333471 0 0 0 DR JIM HARRIS ER PHYSICAN 391750 0 4500 0 45 0 11000 0 31252 0 438547 0 0 0 DR AUSTIN KROHN PROVIDER 248443 0 10000 0 45 0 10724 0 31469 0 300681 0 0 0 CHAD COOPER FORMER CEO (OFFICER) 110605 0 57518 0 15 0 6621 0 9013 0 183772 0 0 0 DR MARK HEGGEM FORMER CMO (KEY EMPLOYEE) 128119 0 8270 0 26 0 5667 0 18306 0 160388 0 0 0 A CITY OF AITKIN 416004918 2016-05-17 5985025 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 B CITY OF MCGREGOR 410906736 2016-05-17 8000000 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 C CITY OF TAMARACK 411315842 2016-05-17 8000000 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 D CITY OF AITKIN 416004918 2017-12-28 9732000 RENOVATE, EXPAND, & EQUIP CLINIC SPACE; BUILD 9 CHAIR KIDNEY DIALYSIS CENTER 0 0 0 A 983208 5985025 89142 5895883 2013 1 0 1 1 B 1314224 8000000 119153 7880847 2013 1 0 1 1 C 1314224 8000000 119153 7880847 2013 1 0 1 1 D 83675 9732000 194640 9537360 2019 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 JENNIFER EHNSTROM FAMILY MEMBER OF BOARD MEMBER JEFFREY EHNSTROM, MD 19386 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 6 RIVERWOOD HEALTHCARE CENTER HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A RIVERWOOD HEALTHCARE CENTER HAS MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE 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 12C OFFICERS, 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 15A RIVERWOOD 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 19 RIVERWOOD 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 11G PHYSICIAN 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. RIVERWOOD HEALTH CARE CENTER FOUNDATION 200 BUNKER HILL DRIVE AITKIN MN 56431 411738787 SUPPORT MN 501(C)(3) LINE 12A, I RIVERWOOD HEALTHCARE CENTER 1 RIVERWOOD MEDICAL PROPERTIES LLC 200 BUNKER HILL DRIVE AITKIN MN 56431 823113322 SUPPORT MN 501(C)(3) LINE 7 RIVERWOOD HEALTHCARE CENTER 1 0 1 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1 1 RIVERWOOD FOUNDATION C 640371 FMV RIVERWOOD FOUNDATION R 80223 FMV RIVERWOOD MEDICAL PROPERTIES C 84306 FMV RIVERWOOD MEDICAL PROPERTIES K 126000 FMV