2017-08-10T14:20:50-05:00 2016-09-30 420714325 RSM US LLP 227 W FIRST ST STE 700 DULUTH MN 558021926 990 2015-10-01 410745522 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER AITK 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 CASEY JOHNSON CFO 2189272121 2017-08-10 1 MARY BETH SANTORI P00023783 2187275025 2015 2021-01-29 14:40:06Z CHAD COOPER 200 BUNKER HILL DRIVE AITKIN MN 56431 75872297 0 X WWW.RIVERWOODHEALTHCARE.COM X 1948 MN INPATIENT AND OUTPATIENT MEDICAL CARE AND THREE PRIMARY CARE CLINICS. 11 10 439 116 8495 0 723951 814613 58026714 59022793 2103456 650842 325324 190207 61179445 60678455 0 0 0 0 26390232 27487544 22204 14240 125504 29366673 30025807 55779109 57527591 5400336 3150864 84910661 81835029 47771545 41122759 37139116 40712270 X TO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 0 0 47649179 59204505 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.HOSPITAL NURSING SERVICES - RIVERWOOD IMPLEMENTED A NEW SOFTWARE SYSTEM, CALLED EXCELLIAN, ON APRIL 1, 2016. EXCELLIAN IS AN ELECTRONIC HEALTH RECORD PLATFORM OF EPIC, ONE OF THE MOST WIDELY USED ELECTRONIC MEDICAL RECORDS. THIS HAS ALLOWED THE HEALTHCARE SYSTEM TO INTEGRATE ITS HOSPITAL AND CLINIC ELECTRONIC RECORDS INTO A SINGLE INTEGRATED SYSTEM AND HAVE IMPROVED CONTINUITY OF CARE. THE FACILITY ALSO STARTED PATIENT FAMILY ADVISORY COUNCIL WITH THE MISSION TO PROVIDE A PATIENT'S POINT OF VIEW AND COLLABORATE WITH THE STAFF TO PROMOTE QUALITY PATIENT AND FAMILY CENTERED CARE. THE COMMITTEE IS MADE UP OF AITKIN COUNTY AREA RESIDENTS WHO GIVE INPUT ON PATIENT AND FAMILY VIEWPOINTS AND NEEDS. TO AIDE IN THE BEST POSSIBLE INPATIENT CARE, ANOTHER INTERNAL MEDICINE PROVIDER WAS ADDED TO HELP OVERSEE PATIENTS.PRIMARY CARE SERVICES - THE HEALTHCARE CENTER HAS LISTENED TO THE COMMUNITY'S REQUESTS AND THEIR WISHES TO HAVE ADVANCED MEDICINE BE DELIVERED LOCALLY SO THAT PATIENTS DON'T HAVE TO TRAVEL OUT OF THE AREA. TO THIS EFFECT, RIVERWOOD IS EMBARKING ON BUILDING A BRAND NEW LOCAL DIALYSIS FACILITY ON THE AITKIN CAMPUS. THIS WILL INCLUDE A NINE CHAIR KIDNEY DIALYSIS UNIT AND SUPPORTING NEPHROLOGY SERVICES THROUGH A PARTNERSHIP WITH CENTRACARE HEALTH. IN ADDITION TO THIS, RIVERWOOD ALSO HAS ADDED TWO NEW FAMILY PHYSICIANS AND ANOTHER NURSE PRACTITIONER TO HELP WITH ACCESS ISSUES FOR WHEN PATIENTS WANT TO SEE A PRIMARY CARE PROVIDER, BUT THERE HAVE NOT BEEN ENOUGH OF THEM AVAILABLE. WITH THE ADDITION OF MORE PROVIDERS, WE'RE WORKING ON ASSURING A TEAM BASED CARE DELIVERY APPROACH USING A PARTNERSHIP OF PRIMARY CARE PROVIDERS, FAMILIES AND PATIENTS WITH THE OVERARCHING GOALS OF IMPROVED HEALTH OUTCOMES, IMPROVED PATIENT EXPERIENCE AND REDUCTION OF HEALTH CARE COST. THIS MODEL OF CARE, A CERTIFIED HEALTHCARE HOME, IS A HIGHER STANDARD OF CARE DELIVERY THAT THE CLINIC VOLUNTARILY CHOOSES TO HOLD THEMSELVES TO. THIS APPROACH CONNECTS PATIENTS TO THE RESOURCES THEY NEED AND ALLOWS THEM TO CONFIDENTLY SELF MANAGE CHRONIC DISEASES AND TO BE IN CONTROL OF THEIR HEALTHCARE CHOICES. RIVERWOOD COLLABORATES WITH LOCAL LAW ENFORCEMENT, REGIONAL MENTAL HEALTH AND AITKIN COUNTY HEALTH AND HUMAN SERVICES TO EXPLORE OFFERING EXPANDED AND MUCH NEEDED MENTAL HEALTH SERVICES AND TO CONTINUE TO OFFER HEALTH AND WELLNESS OPPORTUNITIES AS CHOICES AVAILABLE TO PATIENTS.SURGICAL SERVICES - WITH THE AREA'S ELDERLY POPULATION, APPROXIMATELY 1/3 OF RESIDENTS BEING 65 AND OVER, IN AITKIN COUNTY, THERE IS AN EVER PRESENT NEED FOR ORTHOPEDIC SURGEONS. RIVERWOOD ADDED TWO ADDITIONAL ORTHO SURGEONS TO HELP PROVIDE NEEDED SERVICES TO OUR AREA. SINCE THE CENTER HAS MANY OLDER AND POOR PATIENTS AND IT WORKS TO ACHIEVE HIGH SATISFACTION, RIVERWOOD WAS PLEASE TO BE GIVEN A 5 STAR RATING BASED ON PATIENT SATISFACTION FROM CENTERS OF MEDICARE AND MEDICAID (CMS) AND ALSO RECEIVED A 4 STAR RATING OVERALL IN PATIENT SATISFACTION DATA, QUALITY DATA AND COST DATA FROM CMS. THE ENTIRE TEAM OF HEALTHCARE PROFESSIONALS CONTRIBUTES TO THE DELIVERY OF HIGH QUALITY CARE FOR PATIENTS IN A SAFE ENVIRONMENT. WITH AITKIN COUNTY BEING A HEAVY TOURIST AREA, THIS ENTAILS BRINGING MANY VISITING PEOPLE INTO THE FACILITY AS PATIENTS AS A RESULT OF AN ACCIDENT OR OTHER TRAUMA INCIDENT. TO BE PREPARED FOR BOTH RECREATIONAL AND VEHICULAR TYPES OF INJURIES, RIVERWOOD CONTINUES TO BE A MINNESOTA DEPARTMENT OF HEALTH LEVEL III TRAUMA DESIGNATED FACILITY IN ORDER TO RESPOND TO AND OFFER THE BEST CRITICAL CARE OPTIONS FOR ACCIDENT VICTIMS IN OUR COUNTY. THIS ESTABLISHED PROGRAM, APPROVED BY THE BOARD OF DIRECTORS, MEDICAL AND ANCILLARY STAFF AND HOSPITAL ADMINISTRATION, ENSURES THERE IS A FORMAL TRAUMA PLAN IN PLACE, INCLUDING GENERAL AND ORTHOPEDIC SURGEON RESPONSE, 24 HOUR EMERGENCY ROOM COVERAGE, ETC. TO RESPOND TO CRITICAL NEEDS OF PATIENTS WHO MAY NEED TO COME TO THE EMERGENCY ROOMS OR SURGERY DEPARTMENT.RIVERWOOD CONTINUES TO PROMOTE THE IMPROVEMENT OF THE HEALTH IN THE COMMUNITY BY ENCOURAGING HEALTHY EATING, PHYSICAL ACTIVITY AND WEIGHT MANAGEMENT. WELLNESS COACHING IS AVAILABLE TO ANY INTERESTED PERSON. QUARTERLY NEWSLETTERS ARE SENT TO AITKIN COUNTY AND AREA RESIDENTS, OUTLINING HEALTHY EVENTS SUCH AS 5K RUNS AND WALKS AS WELL AS FITNESS AND WELLNESS PROGRAMS. RIVERWOOD HAS IMPLEMENTED A FARM TO RIVERWOOD PROGRAM THAT BUYS AND SERVES FRESH FARM PRODUCE FROM LOCAL FARMERS AND SERVES TO STAFF AND PATIENTS, IN ADDITION TO SPONSORING THE AITKIN FARMERS MARKET. RIVERWOOD PARTICIPATES WITH THE MINNESOTA DEPARTMENT OF HEALTH AND THE CENTERS FOR DISEASE CONTROL TO HELP PREVENT OBESITY, DIABETES, HEART DISEASE AND STROKE FOR RESIDENTS IN OUR AREA. THE FACILITY SUPPORTS DIABETIC AND HEART DISEASE PATIENTS WITH FREE USE OF BLOOD PRESSURE MONITORS, SCALES, GLUCOMETERS AND THE SUPPORT OF HEALTHCARE STAFF IN MONITORING THESE PATIENTS. A 16 WEEK NATIONAL DIABETES PREVENTION PROGRAM CLASS IS AVAILABLE TO ANYONE INTERESTED. FOR PATIENT'S FINANCIAL NEEDS, RIVERWOOD OFFERS FINANCIAL COUNSELING AND WORKS ACTIVELY WITH UNINSURED PATIENTS TO IDENTIFY ANY AND ALL HEALTH INSURANCE COVERAGE OPTIONS IN SUPPORT OF ENHANCED ACCESS TO HEALTHCARE. THE CENTER WORKS WITH TOWARD ZERO DEATHS (TZD), A MINNESOTA TRAFFIC SAFETY PROGRAM, TO HELP PREVENT HARM TO INDIVIDUALS FROM INJURIES AND VIOLENCE. STAFF WORK WITH TZD TO PROMOTE AWARENESS OF THE DANGERS BOTH TEXTING AND DRINKING AND DRIVING. RIVERWOOD IS WORKING WITH LOCAL LAW ENFORCEMENT AND AITKIN COUNTY HEALTH AND HUMAN SERVICES TO EVALUATE THE FEASIBILITY OF DEVELOPING VIVATROL OFFERING TO RIVERWOOD PATIENTS WHO ARE SUFFERING FROM HEROIN AND OPIOD WITHDRAWAL. OFFERINGS OF EDUCATION ON PRESCRIPTION DRUG DEPENDENCE AND HOW TO PREVENT IS AVAILABLE TO THE PUBLIC VIA PRESENTATIONS, NEWS ARTICLES AND SOCIAL MEDIA AND GIVEN BY RIVERWOOD HEALTH PROFESSIONALS. 47649179 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 52 0 1 439 1 1 1 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 JEFF EHNSTROM MD DIRECTOR/PHYSICIAN 40.00 X 289498 0 32616 STEVE WILSON DIRECTOR 1.00 X 0 0 0 ALISON MATALAMAKI TREASURER 1.00 X X 0 0 0 MIKE PAULBECK CHAIRMAN 1.00 X X 0 0 0 JARED LUNDGREN DIRECTOR 1.00 X 0 0 0 TOM LUNDBERG DIRECTOR 1.00 X 0 0 0 TIMOTHY DIRKS MD DIRECTOR 1.00 X 0 0 0 DAVID MEYER SECRETARY 1.00 X X 0 0 0 KATHLEEN RYAN DIRECTOR 1.00 X 0 0 0 CHAD GROSS VICE CHAIRMAN 1.00 X X 0 0 0 CHRISTINE BRIGHT DIRECTOR 1.00 X 0 0 0 CHAD COOPER CEO 39.90 0.10 X 416676 0 31816 CASEY JOHNSON CFO 39.90 0.10 X 152469 0 29601 MARK HEGGEM MD CMO 40.00 X 296055 0 15999 JEFFREY RAPP MD PHYSICIAN 40.00 X 325586 0 29071 JIM HARRIS MD ER MEDICAL DIRECTOR 40.00 X 335769 0 28533 DAVID TAYLOR MD PHYSICIAN 40.00 X 269046 0 11773 DONALD HUGHES MD PHYSICIAN 40.00 X 257654 0 29475 JOSELITO BURGOS JR MD PHYSICIAN 40.00 X 258268 0 34527 2601021 0 243411 41 0 1 0 CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN CROSBY MN 56441 PROF MEDICAL SERVICES 2469960 CENTRAL MINNESOTA DIAGNOSTICS INC 150 10TH STREET NW MILACA MN 56353 PROF IMAGING SERVICES 1384906 LIFE GUARD ANESTHESIA SERVICES INC 29561 395TH PLACE AITKIN MN 56431 PROF ANESTHESIA SERVICES 1231180 PREMIER SURGICAL ASSOCIATES PA 318 E MAIN ST CROSBY MN 56441 PROF SURGICAL SVCS 545213 WAPITI MEDICAL - CONNECT HEALTHCARE 107 FLYNN DR 600 MILBANK SD 57252 PROF MEDICAL SERVICES 276919 9 197761 505649 111203 814613 NET PATIENT SERVICE REVENUE 621500 58483646 58483646 EQUITY IN EARNINGS OF AFFILIATES 900099 347897 339402 8495 ELECTRONIC HEALTH RECORD INCENTIV 621500 191250 191250 59022793 895884 895884 14945345 3455 15193291 551 -247946 2904 -245042 -245042 OTHER REVENUE 900099 190207 190207 190207 60678455 59204505 8495 650842 1336716 397192 939524 21014307 18032345 2887937 94025 773151 689782 83369 2937381 2588525 348856 1425989 1233609 192380 76230 76230 100266 100266 14240 14240 2487159 2469920 17239 1533819 1273070 260749 3708493 3078049 630444 246619 246619 HOSPITAL SUPPLIES & OTH 10927825 10927825 NURSING SUPPLIES & OTHE 7509424 7509424 OTHER GENERAL SERVICE S 1238785 1238785 PROVISION FOR DOUBTFUL 680573 680573 1516614 1516614 57527591 47649179 9752908 125504 1757467 15708 4892346 335845 7868756 14248725 1439531 1526643 543421 435898 63773310 35144677 29165995 28628633 29391966 28497776 9851179 8145801 84910661 81835029 9441384 6521073 20895000 23429624 17435161 11172062 47771545 41122759 X 36261600 39868052 877516 844218 37139116 40712270 84910661 81835029 X 3150864 1007014 -584724 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2171 2171 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. 530721 10600 38231 15000 564552 558330 75 -22684 5000 530721 406564 134710 27056 2000 8000 558330 380978 15063 26281 15758 406564 330207 1250 52521 3000 380978 0.37600 0.47550 0.14850 0 1 1 1312070 1312070 32886968 14169729 18717239 25594291 18667499 6926792 3979981 2307449 1672532 28628633 ASSETS LIMITED FOR RESERVE ACCOUNTS 688320 BENEFICIAL INTEREST IN NET ASSETS-HOSPITAL FOUNDATION 844218 INVESTMENT IN CENTRAL MINNESOTA DIAGNOSTICS, INC. 1128325 ASSETS LIMITED BY AGREEMENT FOR DEFERRED COMPENSATION 1142437 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1359000 ASSETS LIMITED BY AGREEMENT FOR WORKER'S COMPENSATION 238000 ASSETS LIMITED BY BOARD FOR FUNDED DEPRECIATION 2745501 8145801 REVENUE NOTE PAYABLE 11172062 11172062 X 60417268 1007014 -1265297 -258283 60675551 2904 2904 60678455 56844114 -2904 -2904 56847018 680573 680573 57527591 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: NOT-FOR-PROFIT 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 CENTER 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 2013. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL RECEIVABLES -680,573. DECREASE IN INTEREST IN NET ASSETS - AITKIN COMMUNITY HOSPITAL FOUNDATION -33,298. LOSS ON EXTINGUISHMENT OF DEBT -551,426. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT 2,904. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT -2,904. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL RECEIVABLES 680,573. 1 1 1 X 1 X 1 1 0 1 1 896812 896812 0.01580 7977726 6605669 1372057 0.02410 8874538 6605669 2268869 0.03990 738363 738363 0.01300 30664 30664 0.00050 769027 769027 0.01350 9643565 6605669 3037896 0.05340 1 680573 387926 21700744 21806210 -105466 X 1 1 1 1 RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN MN 56431 X X X X AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X SEE PART V, PAGE 7 X SEE PART V, PAGE 7 X 1 15 0 1 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 7 X SEE PART V, PAGE 7 X SEE PART V, PAGE 7 X X X X X X 1 X 0 X X X X 1 X 0 0 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART V, SECTION B, LINE 5: RIVERWOOD HEALTHCARE CENTER SELECTED A GROUP OF 150 LOCAL RESIDENTS AND RECOMMENDED THE NAMES TO THE INDEPENDENT VENDOR RESEARCH CONSULTANTS, INC. (PRC), FOR INCLUSION IN AN ONLINE QUESTIONNAIRE. THE RESPONSES TO THE QUESTIONNAIRE WERE USED TO A FORM A COMMUNITY HEALTH PANEL. OF THE TOTAL ABOVE, 102 RESPONSES WERE RECEIVED BACK. FEEDBACK AND RESPONSES WERE RECEIVED FROM AREA SCHOOL DISTRICTS, LOCAL LAW ENFORCEMENT, AITKIN COUNTY HEALTH AND HUMAN SERVICES, AREA BUSINESSES AND COMMUNITY LEADERS, AND AREA HEALTHCARE PROFESSIONALS. 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 OF 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 CHNA IS THE HOSPITAL/COMMUNITY PLAN FOR ADDRESSING THE COMMUNITY HEALTH NEEDS. IRS NOTICE 2011-52 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 HEALTHCARE CENTER'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 SIX CRITICAL STRATEGIC GOALS:(1) QUALITY: OUR CUSTOMERS ARE DEMANDING MORE EFFICIENCY, BETTER QUALITY, AND SUPERIOR SAFETY. WE WILL LEAD IN DELIVERING ON THESE REQUIREMENTS THROUGH IMPROVED DATA, REPORTING AND PROCESS IMPROVEMENTS.(2) PEOPLE: OUR PEOPLE ARE KEY. WE WILL INSPIRE THEIR TRUST, IMPROVE THEIR SKILLS, AND DEVELOP LEADERSHIP AND ENGAGEMENT THAT LEADS US INTO A STRONGER FUTURE.(3) STEWARDSHIP: WE WILL ACHIEVE OPERATING MARGINS THAT ENSURE LONG-TERM FINANCIAL STRENGTH AND THE CAPACITY TO CONTINUE TO INVEST FOR THE BENEFIT OF PATIENTS AND FAMILIES.(4) GROWTH: WE WILL GROW OUR PRIMARY CARE SERVICES AND SHARE OF OUR MARKET. WE INTEND TO BUILD THE CONFIDENCE OF OUR COMMUNITY IN THEIR ABILITY AND DESIRE TO STAY LOCAL FOR CARE AND KNOW THAT WHEN THEY NEED SPECIALIZED OR TERTIARY CARE WE WILL MAKE THE TRANSITION EASY.RIVERWOOD'S ADDRESSING OF NEEDSRIVERWOOD'S IMPLEMENTATION STRATEGY WILL ADDRESS ALL THE IDENTIFIED PRIORITIES. PRIORITY HEALTH ISSUES TO BE ADDRESSED WILL FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE: 1) MENTAL HEALTH 2) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT 3) HEART DISEASE AND STROKE4) DIABETES5) ACCESS TO HEALTHCARE SERVICES6) INJURY AND VIOLENCE 7) SUBSTANCE ABUSETHE ONLY ISSUES THAT WILL NOT BE ADDRESSED IS FAMILY PLANNING, SINCE THE HOSPITAL HAS LIMITED RESOURCES TO ADDRESS UNINTENDED PREGNANCIES FOR TEENS. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS TO BETTER MEET THE NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA FOR ACTION.CONCLUSION IN ADDITION TO SPECIFIC STRATEGIES AND MISSION DRIVEN PROGRAMS, RIVERWOOD HEALTHCARE CENTER WILL CONTINUE TO BUILD ITS PATIENT-CENTERED HEALTHCARE HOME (PCHH) AS IT ADDRESSES COMMUNITY NEEDS. IT IS WHAT ALIGNS WITH THE HOSPITAL STRATEGIC PLAN AND WITH THE CHNA. WE KNOW THAT THE PCHH IS NOT ONLY THE WAVE OF THE FUTURE, BUT WILL POSITIVELY IMPACT THE HEALTH OF THE PEOPLE OF AITKIN COUNTY. RHCC BUILDS EVALUATIVE MEASURES AND GOALS INTO ALL OF ITS PROGRAMS AND SERVICES. IN ADDITION, THE CHNA PLAN IS REVIEWED AND REWRITTEN EVERY 3 YEARS. RHCC'S MANAGEMENT TEAM WILL CONTINUE TO PLAY A LEADERSHIP ROLE IN THE IMPLEMENTATION STRATEGIES AND MONITOR ITS PROGRESS, AND MAKE ADJUSTMENTS TO STRATEGIES AS NEEDED. AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART V, SECTION B, LINE 16I: 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 QUALITY 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 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 GETS 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 MAKE CONTACT AFTER DISCHARGE FROM THE FACILITY. PART V, SECTION B, LINE 7A HTTP://RIVERWOODHEALTHCARE.ORG/WP-LIB/WP-CONTENT/UPLOADS/2016/10/2016-RHCC-CHNA-REPORT-AITKIN-COUNTY-MN.PDF PART V, SECTION B, LINE 16A HTTP://RIVERWOOD.SERVER297.COM/WP-LIB/WP-CONTENT/UPLOADS/2016/05/RHCC-COMMUNITY-CARE-AND-UNINSURED-PROGRAM.PDF PART V, SECTION B, LINE 16B HTTP://RIVERWOOD.SERVER297.COM/WP-LIB/WP-CONTENT/UPLOADS/2016/05/RHCC-COMMUNITY-CARE-AND-UNINSURED-PROGRAM.PDF PART V, SECTION B, LINE 16C HTTP://RIVERWOOD.SERVER297.COM/WP-LIB/WP-CONTENT/UPLOADS/2016/05/RHCC-COMMUNITY-CARE-AND-UNINSURED-PROGRAM.PDF PART V, SECTION B, LINE 7B HTTP://AITKINCOUNTY.HEALTHFORECAST.NET/2016%20PRC%20CHNA%20REPORT%20-%20AITKIN%20COUNTY,%20MN.PDF 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 2016 MEDICARE COST REPORT. PART I, LN 7 COL(F): BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS $680,573. 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: MANAGEMENT DETERMINES THE ALLOWANCES FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND THEN USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PART III, LINE 3: THE HOSPITAL LOOKS AT THE NUMBER OF CHARITY CARE APPLICATIONS SENT TO POTENTIAL APPLICANTS AND COMES UP WITH AN APPROVAL RATIO BASED ON RETURNED APPLICATIONS. THE PERCENTAGE OF UNRETURNED APPLICATIONS IS THEN MULTIPLIED BY THE TOTAL DOLLAR AMOUNT OF BAD DEBT EXPENSE. 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 ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS A PERCENTAGE OF PRIVATE-PAY RECEIVABLE HAS INCREASED FROM 48.4 PERCENT FOR THE YEAR ENDED SEPTEMBER 30, 2015, TO 61.3 PERCENT FOR THE YEAR ENDED SEPTEMBER 30, 2016.THE CENTER HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2016 OR 2015. THE CENTER DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD PARTY PAYORS." PART III, LINE 8: THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND THUS IS REIMBURSED AT 101% OF COST. THE MEDICARE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $790,868 AND ALLOWABLE COSTS OF $1,472,531 RESULTING IN A SHORTFALL OF $681,663. THE SHORTFALL IS THE RESULT OF UNREIMBURSED PROFESSIONAL CARE. THE MEDICARE ADVANTAGE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $5,087,740 AND ALLOWABLE COSTS OF $5,128,265 RESULTING IN A SHORTFALL OF $40,525.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: 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: 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 OR SLIDING FEE SCALE 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 SLIDING FEE SCALE 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: AITKIN COMMUNITY HOSPITAL, INC. D.B.A. RIVERWOOD HEALTHCARE 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. 16,149) THE EAST SIDE OF CROW WING COUNTY (POP. 61,009) AND MILLE LACS COUNTY (POP. 26,169). THE GEOGRAPHIC AREA OF THESE COUNTIES IS RURAL.SPECIAL POPULATIONS SERVED INCLUDE THOSE WITH A HIGH RATE OF POVERTY AND UNEMPLOYMENT WITH AITKIN, CROW WING AND MILLE LACS COUNTIES. IN 2007, THE ESTIMATED PERCENTAGES OF THESE THREE COUNTIES WITH POPULATIONS BELOW POVERTY LEVEL WERE RESPECTIVELY: AITKIN - 13.4%, CROW WING - 9.3%, MILLE LACS - 9.5%. ADDITIONALLY, ACCORDING TO THE MINNESOTA DEPARTMENT OF EMPLOYMENT AND ECONOMIC DEVELOPMENT, THE UNEMPLOYMENT RATE IN AITKIN COUNTY SKYROCKETED TO 10.5% IN JANUARY 2009, WHICH IS NEARLY 4 PERCENTAGE POINTS OVER THE STATE AVERAGE OF 6.9%. THE DEPARTMENT OF LABOR AND INDUSTRY CONSIDERS AITKIN COUNTY TO BE A "LABOR SURPLUS AREA". 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. POPULATION PROJECTIONS INDICATE THAT BETWEEN THE YEARS OF 2005-2030, A 50% OVERALL INCREASE IS EXPECTED IN AITKIN COUNTY WITH THE 65+ AGE GROUP BY 120%. AITKIN COUNTY IS SECOND ONLY TO TRAVERSE COUNTY FOR HAVING THE OLDEST MEDIAN POPULATION IN MINNESOTA. PART VI, LINE 5: IN FURTHERANCE OF ITS CHARITABLE PURPOSE, 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. ADDITIONALLY, 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. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X X X 0 0 0 0 0 0 0 1 0 JEFF EHNSTROM MD DIRECTOR/PHYSICIAN 282568 0 6930 0 0 0 10600 0 22016 0 322114 0 0 0 CHAD COOPER CEO 350716 0 58760 0 7200 0 10600 0 21216 0 448492 0 0 0 CASEY JOHNSON CFO 143429 0 9040 0 0 0 5845 0 23756 0 182070 0 0 0 MARK HEGGEM MD CMO 287015 0 9040 0 0 0 10600 0 5399 0 312054 0 0 0 JEFFREY RAPP MD PHYSICIAN 325586 0 0 0 0 0 10600 0 18471 0 354657 0 0 0 JIM HARRIS MD ER MEDICAL DIRECTOR 335769 0 0 0 0 0 10600 0 17933 0 364302 0 0 0 DAVID TAYLOR MD PHYSICIAN 269046 0 0 0 0 0 10600 0 1173 0 280819 0 0 0 DONALD HUGHES MD PHYSICIAN 249950 0 7704 0 0 0 10600 0 18875 0 287129 0 0 0 JOSELITO BURGOS JR MD PHYSICIAN 252040 0 6228 0 0 0 10600 0 23927 0 292795 0 0 0 PART I, LINE 3 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. PART I, LINE 7 RIVERWOOD MAINTAINS AN INCENTIVE COMPENSATION PROGRAM FOR CERTAIN MEMBERS OF EXECUTIVE LEADERSHIP WHICH PUTS A CERTAIN AMOUNT OF COMPENSATION AT RISK. PAYMENT OF ANY INCENTIVE COMPENSATION IS MADE BASED UPON ACHIEVEMENT OF CERTAIN ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL OUTCOMES, QUALITY OUTCOMES, AND OTHER KEY MEASURES AS DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. 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 A 95371 5985025 89142 5895883 2013 1 0 1 1 B 127479 8000000 119153 7880847 2013 1 0 1 1 C 127479 8000000 119153 7880847 2013 1 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 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 A 1 B 1 C 1 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 11 THE FINANCE COMMITTEE REVIEWS AND APPROVES THE 990 AFTER PREPARATION AND RECOMMENDS APPROVAL TO THE BOARD. AFTER APPROVAL BY THE BOARD, 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 FOR THE CEO IN THE LATER PART OF CALENDAR YEAR 2016. FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL REPORT, WHICH PROVIDES AN OVERVIEW OF THE ORGANIZATION'S FINANCIAL STATUS, IS MADE AVAILABLE TO THE PUBLIC FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IT IS MAILED TO MEMBERS OF THE ORGANIZATION, ORGANIZATIONS THAT WE HAVE FINANCING WITH, AND IS AVAILABLE ON OUR WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART XI, LINE 9: DECREASE IN INTEREST IN NET ASSETS OF AITKIN COMMUNITY HOSPITAL FOUNDATION -33,298. LOSS ON EXTINGUISHMENT OF DEBT -551,426. RIVERWOOD HEALTH CARE CENTER FOUNDATION 200 BUNKER HILL DRIVE AITKIN MN 56431 411738787 SUPPORT MN 501(C)(3) LINE 11A, I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0