AITKIN COMMUNITY HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- AITKIN COMMUNITY HOSPITAL INC (EIN 41-0745522)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-14
- IRS object ID
- 201422269349303812
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-14T15:00:14-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 W FIRST ST STE 700 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 558021919 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410745522 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AITKIN COMMUNITY HOSPITAL DBA | BusinessNameLine1 |
| Business Name Line2 | RIVERWOOD HEALTHCARE CENTER | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AITK | NameControl |
| Phone | 2189272121 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BUNKER HILL DRIVE | AddressLine1 |
| City | AITKIN | City |
| State | MN | State |
| ZIP Code | 56431 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CASEY JOHNSON | Name |
| Title | CFO | Title |
| Phone | 2189272121 | Phone |
| Date Signed | 2014-08-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY BETH SANTORI | Name |
| PTIN | P00023783 | PTIN |
| Phone | 2187275025 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHAD COOPER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BUNKER HILL DRIVE | AddressLine1 |
| City | AITKIN | City |
| State | MN | State |
| ZIP Code | 56431 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 61375324 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RIVERWOODHEALTHCARE.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1948 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | INPATIENT AND OUTPATIENT MEDICAL CARE AND THREE PRIMARY CARE CLINICS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 407 | TotalNbrEmployees |
| Total Nbr Volunteers | 125 | TotalNbrVolunteers |
| Total Gross UBI | 832697 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -74027 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 971207 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 671522 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 48022653 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 51932652 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 871727 | InvestmentIncomePriorYear |
| Investment Income Current Year | 945158 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 282519 | OtherRevenuePriorYear |
| Other Revenue Current Year | 358544 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 50148106 | TotalRevenuePriorYear |
| Total Revenue Current Year | 53907876 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23772250 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 25370019 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 40170 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 38801 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 814711 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 23832628 | OtherExpensePriorYear |
| Other Expenses Current Year | 26570151 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 47645048 | TotalExpensesPriorYear |
| Total Expenses Current Year | 51978971 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2503058 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1928905 | RevenuesLessExpensesCY |
| Total Assets BOY | 76475801 | TotalAssetsBOY |
| Total Assets EOY | 75825894 | TotalAssetsEOY |
| Total Liabilities BOY | 47846263 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 45417709 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 28629538 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 30408185 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PROVIDE HIGH QUALITY INPATIENT AND OUTPATIENT CARE AND THREE PRIMARY CLINICS CARE TO THE RESIDENTS OF AITKIN AND THE SURROUNDING AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 43103627 | Expense |
| Revenue | 51458499 | Revenue |
| Description | RIVERWOOD HEALTHCARE CENTER EXISTS TO ENHANCE AND IMPROVE THE HEALTH AND WELLBEING OF RESIDENTS OF AITKIN COUNTY AND THE SURROUNDING AREA BY PROVIDING A COMPREHENSIVE ARRAY OF MEDICAL SERVICES CLOSE TO HOME. RIVERWOOD HEALTHCARE CENTER OPERATES A CRITICAL ACCESS, 25-BED HOSPITAL LOCATED IN AITKIN, MINN. SERVICES INCLUDE 24-HOUR EMERGENCY CARE WITH COMPREHENSIVE ADVANCED LIFE SUPPORT (CALS) HOSPITAL, LEVEL I HEART ATTACK PROGRAM AND LEVEL III TRAUMA DESIGNATIONS, INTENSIVE/CORONARY CARE, URGENT CARE, INPATIENT AND OUTPATIENT SURGERY WITH MANY MINIMALLY INVASIVE PROCEDURES, BIRTHING SUITES, A WIDE RANGE OF SPECIALTY CARE, REHABILITATION SERVICES AND MORE. RIVERWOOD OFFERS OUTPATIENT CARE AT CLINICS IN AITKIN, GARRISON AND MCGREGOR. RIVERWOOD IS STAFFED BY APPROXIMATELY 350 HEALTHCARE PROFESSIONALS. RIVERWOOD ALSO HAS A STRONG FOCUS ON HEALTH AND WELLNESS AND STRIVES TO EDUCATE AND INFORM THE COMMUNITY ON HEALTH ISSUES. RIVERWOOD OFFERS COMMUNITY HEALTH EDUCATION SEMINARS, SUPPORT GROUPS AND CLASSES AS WELL AS HEALTH AND WELLNESS TIPS IN OUR HEALTHY LIVING NEWSLETTER.IN JANUARY 2013, RIVERWOOD LAUNCHED A MAJOR WELLNESS INITIATIVE WITH A $475,000 GRANT FUNDED BY ALLINA HEALTHY AND THE GEORGE FAMILY FOUNDATION. WITH THESE FUNDS FROM THE HEALTHY COMMUNITIES PARTNERSHIP PROJECT TARGETING 13 COMMUNITIES IN MINNESOTA AND WESTERN WISCONSIN, A HEALTH AND WELLNESS COACH AND A WELLNESS COORDINATOR WERE HIRED TO PROMOTE EDUCATION AND COMMUNITY OUTREACH TO REDUCE OBESITY AND ENCOURAGE HEALTHY LIFESTYLES AMONG RIVERWOOD PATIENTS AND COMMUNITY MEMBERS.IN MAY 2013, RIVERWOOD COMPLETED A 2-YEAR HOSPITAL EXPANSION AND RENOVATION PROJECT, WHICH CONVERTED 13 SEMI-PRIVATE HOSPITAL ROOMS TO 25 SINGLE OCCUPANCY ROOMS. THIS PROJECT INCLUDED THE CREATION OF A LARGER, MORE PRIVATE BIRTHING CENTER, A LARGER INFUSION CENTER, AND A NEW WING FOR SUPPORT SERVICES, AS WELL AS MAKEOVERS FOR THE INTENSIVE CARE UNIT, SURGERY, REHABILITATION, LAB, PHARMACY AND CARDIOPULMONARY DEPARTMENTS.DERMATOLOGY CARE FROM DERMATOLOGY PROFESSIONALS OF BAXTER, MN, WAS ADDED TO THE RANGE OF CARE OFFERED AT RIVERWOOD'S SPECIALTY CLINIC IN AITKIN. | Description |
| Total Program Service Expense | 43103627 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 1 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 53 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 407 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUDY TURNER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2189272121 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BUNKER HILL DRIVE | AddressLine1 |
| City | AITKIN | City |
| State | MN | State |
| ZIP Code | 56431 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| THOMAS RIKALA | ||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| JOHN W NEWSTROM | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DR SANDRA KILDE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JEFF EHNSTROM MD | ||||||||
| DIRECTOR/PHYSICIAN | 41.00 | X | X | 301086 | 0 | 27822 | ||
| ROBERT LEWIS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| STEVE WILSON | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| ALISON MATALAMAKI | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| MIKE PAULBECK | ||||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| MARK HEGGEM MD | ||||||||
| CMO/DIRECTOR | 41.00 | X | 271799 | 0 | 27822 | |||
| JAMES HAWLEY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JARED LUNDGREN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| TOM LUNDBERG | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| TIM DIRKS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CHAD GROSS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL HAGEN | ||||||||
| CEO - FORMER | 39.90 | X | 282279 | 0 | 33822 | 0.10 | ||
| KENT DUMONSEAU | ||||||||
| CFO - FORMER | 39.90 | X | 82971 | 0 | 13379 | 0.10 | ||
| CHAD COOPER | ||||||||
| CEO | 39.90 | X | 0 | 0 | 0 | 0.10 | ||
| GORDY FORBORT | ||||||||
| INTERIM CFO | 19.90 | X | 50280 | 0 | 0 | 0.10 | ||
| STEVEN PITSCHKA MD | ||||||||
| PHYSICIAN | 40.00 | 347154 | 0 | 19228 | X | |||
| JEFFREY RAPP MD | ||||||||
| PHYSICIAN | 40.00 | 343729 | 0 | 27822 | X | |||
| JIM HARRIS MD | ||||||||
| ER MEDICAL DIRECTOR | 40.00 | 311991 | 0 | 27822 | X | |||
| DAVID TAYLOR MD | ||||||||
| PHYSICIAN | 40.00 | 303245 | 0 | 19228 | X | |||
| THOMAS OSBORNE MD | ||||||||
| PHYSICIAN | 40.00 | 329683 | 0 | 27822 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2624217 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 224767 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CENTRAL MINNESOTA DIAGNOSTICS INC | |||||
| 150 10TH STREET NW | MILACA | MN | 56353 | MED SVCS - RADIOLOGY | 1274157 |
| LIFE GUARD ANESTHESIA SERVICES INC | |||||
| 29561 395TH PLACE | AITKIN | MN | 56431 | PROF SVCS - ANESTHESIA | 1099360 |
| SISU MEDICAL SOLUTIONS LLC | |||||
| 5 W 1ST ST | DULUTH | MN | 55802 | PROF SVCS - IT | 461696 |
| PREMIER SURGICAL ASSOCIATES PA | |||||
| 318 E MAIN | CROSBY | MN | 56441 | PROF SVCS - SURGICAL | 419110 |
| CUYUNA REGIONAL MEDICAL CENTER | |||||
| 320 E MAIN | CROSBY | MN | 56441 | MED & PROF SVCS - SURG, CARDIAC, LAB, AN | 241013 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Related Organizations | 330286 | RelatedOrganizations |
| All Other Contributions | 341236 | AllOtherContributions |
| Total Contributions | 671522 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621500 | 50232586 | 50232586 | |
| GARRISON PHARMACY | 446110 | 813063 | 813063 | |
| ELECTRONIC HEALTH RECORD INCENTIV | 621500 | 584780 | 584780 | |
| EQUITY IN EARNINGS OF AFFILIATES | 900099 | 302223 | 282589 | 19634 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 51932652 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 682189 | TotalRevenueColumn |
| Exclusion | $682,189 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7728777 | Securities |
| Other | 1640 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7466475 | Securities |
| Other | 973 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 262302 | Securities |
| Other | 667 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 262969 | TotalRevenueColumn |
| Exclusion | $262,969 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 358544 | TotalRevenueColumn |
| Related Or Exempt Function Income | 358544 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 358544 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53907876 | TotalRevenueColumn |
| Related Or Exempt Function Income | 51458499 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 832697 | UnrelatedBusinessRevenue |
| Exclusion | $945,158 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1257978 | Total |
| Program Services | 647341 | ProgramServices |
| Management And General | 610637 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19038564 | Total |
| Program Services | 16234255 | ProgramServices |
| Management And General | 2550948 | ManagementAndGeneral |
| Fundraising | 253361 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 674814 | Total |
| Program Services | 623847 | ProgramServices |
| Management And General | 41528 | ManagementAndGeneral |
| Fundraising | 9439 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3009640 | Total |
| Program Services | 2758850 | ProgramServices |
| Management And General | 209832 | ManagementAndGeneral |
| Fundraising | 40958 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1389023 | Total |
| Program Services | 1258046 | ProgramServices |
| Management And General | 112538 | ManagementAndGeneral |
| Fundraising | 18439 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134886 | Total |
| Management And General | 129985 | ManagementAndGeneral |
| Fundraising | 4901 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91126 | Total |
| Management And General | 91126 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38801 | Total |
| Fundraising | 38801 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2204106 | Total |
| Management And General | 1842522 | ManagementAndGeneral |
| Fundraising | 361584 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1988127 | Total |
| Program Services | 1640685 | ProgramServices |
| Management And General | 315546 | ManagementAndGeneral |
| Fundraising | 31896 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3448931 | Total |
| Program Services | 2846201 | ProgramServices |
| Management And General | 547398 | ManagementAndGeneral |
| Fundraising | 55332 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 288282 | Total |
| Management And General | 288282 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| HOSPITAL SUPPLIES & OTH | 8946338 | 8946338 |
| NURSING SUPPLIES & OTHE | 5590799 | 5590799 |
| OTHER GENERAL SERVICE S | 1361478 | 1361478 |
| PROVISION FOR DOUBTFUL | 1195787 | 1195787 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1320291 | Total |
| Management And General | 1320291 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51978971 | Total |
| Program Services | 43103627 | ProgramServices |
| Management And General | 8060633 | ManagementAndGeneral |
| Fundraising | 814711 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 259779 | BOY |
| EOY | 234391 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2354304 | BOY |
| EOY | 3151342 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6266474 | BOY |
| EOY | 6761690 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1220106 | BOY |
| EOY | 1309694 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 425889 | BOY |
| EOY | 697070 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 58918335 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26008213 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32908045 | BOY |
| EOY | 32910122 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22085980 | BOY |
| EOY | 23676675 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10955224 | BOY |
| EOY | 7084910 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76475801 | BOY |
| EOY | 75825894 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6426898 | BOY |
| EOY | 4822644 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25364352 | BOY |
| EOY | 24562176 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16055013 | BOY |
| EOY | 16032889 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47846263 | BOY |
| EOY | 45417709 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27568449 | BOY |
| EOY | 29503404 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1061089 | BOY |
| EOY | 904781 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28629538 | BOY |
| EOY | 30408185 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76475801 | BOY |
| EOY | 75825894 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1928905 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6050 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -156308 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $1,770 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1770 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | 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. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 380978 | BeginningOfYearBalance |
| Contributions | 15063 | Contributions |
| Investment Earnings Or Losses | 26281 | InvestmentEarningsOrLosses |
| Administrative Expenses | 15758 | AdministrativeExpenses |
| End Of Year Balance | 406564 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 330207 | BeginningOfYearBalance |
| Contributions | 1250 | Contributions |
| Investment Earnings Or Losses | 52521 | InvestmentEarningsOrLosses |
| Administrative Expenses | 3000 | AdministrativeExpenses |
| End Of Year Balance | 380978 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 331439 | BeginningOfYearBalance |
| Contributions | 1590 | Contributions |
| Investment Earnings Or Losses | -1822 | InvestmentEarningsOrLosses |
| Administrative Expenses | 1000 | AdministrativeExpenses |
| End Of Year Balance | 330207 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 203149 | BeginningOfYearBalance |
| Contributions | 17190 | Contributions |
| Investment Earnings Or Losses | 22131 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | -90969 | GrantsOrScholarships |
| Administrative Expenses | 2000 | AdministrativeExpenses |
| End Of Year Balance | 331439 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 195213 | BeginningOfYearBalance |
| Contributions | 7315 | Contributions |
| Investment Earnings Or Losses | 3221 | InvestmentEarningsOrLosses |
| Administrative Expenses | 2600 | AdministrativeExpenses |
| End Of Year Balance | 203149 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.47530 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.29880 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.22590 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1258670 | OtherCostOrOtherBasis |
| Book Value | 1258670 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32192724 | OtherCostOrOtherBasis |
| Depreciation | 9743880 | Depreciation |
| Book Value | 22448844 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21490976 | OtherCostOrOtherBasis |
| Depreciation | 14636797 | Depreciation |
| Book Value | 6854179 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3975965 | OtherCostOrOtherBasis |
| Depreciation | 1627536 | Depreciation |
| Book Value | 2348429 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 32910122 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (11 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ASSETS LIMITED FOR RESERVE ACCOUNTS | 1937760 |
| ASSETS LIMITED FOR PRINCIPAL & INTEREST PAYMENTS | 690481 |
| BENEFICIAL INTEREST IN NEW ASSETS-HOSPITAL FOUNDATION | 904781 |
| BOND ISSUE COSTS, NET OF ACCUMULATED AMORTIZATION | 682397 |
| INVESTMENT IN CENTRAL MINNESOTA DIAGNOSTICS, INC. | 1206390 |
| INVESTMENT IN SISU MEDICAL SYSTEMS | 515 |
| INVESTMENT IN SISU MEDICAL SOLUTIONS, LLC | 54652 |
| ASSETS LIMITED BY AGREEMENT FOR DEFERRED COMPENSATION | 663566 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | 338500 |
| ASSETS LIMITED FOR CONSTRUCTION | 367868 |
| ASSETS LIMITED BY AGREEMENT FOR WORKER'S COMPENSATION | 238000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 7084910 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| BOND PREMIUM | $50,390 |
| REVENUE NOTE PAYABLE | $15,982,499 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 16032889 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 52561164 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 6050 | NetUnrealizedGainsInvestments |
| Other Revenues | -1352095 | OtherRevenues |
| Revenue Not Rptd F990 | -1346045 | RevenueNotRptdF990 |
| Revenue Subtotal | 53907209 | RevenueSubtotal |
| Other Revenues Not Included | 667 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 667 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 53907876 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 50782517 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -667 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -667 | ExpensesNotRptdF990 |
| Expenses Subtotal | 50783184 | ExpensesSubtotal |
| Other Expenses Not Included | 1195787 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1195787 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 51978971 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | 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. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | 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. NOT-FOR-PROFIT 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 2010. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL RECEIVABLES -1,195,787. DECREASE IN INTEREST IN NET ASSETS - AITKIN COMMUNITY HOPSITAL FOUNDATION -156,308. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | GAIN ON SALE OF EQUIPMENT 667. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | GAIN ON SALE OF EQUIPMENT -667. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL RECEIVABLES 1,195,787. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Solicitation Of Govt Grants | X | SolicitationOfGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
Name Of Organization NameOfOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HBH CONSULTANTS LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 340 10TH STREET NW | AddressLine1 |
| City | MILACA | City |
| State | MN | State |
| ZIP Code | 56353 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | CONSULTING | Activity |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFunds |
| Gross Receipts | 374265 | GrossReceipts |
| Amount Retained By Contractor | 38801 | AmountRetainedByContractor |
| Net To Organization | 335464 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 374265 | TotalGrossReceipts |
| Total Retained By Contractors | 38801 | TotalRetainedByContractors |
| Total Net To Organization | 335464 | TotalNetToOrganization |
| Licensed States | MN | LicensedStates |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 935599 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 935599 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01840 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6756898 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4634589 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2122309 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04180 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7692497 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4634589 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3057908 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06020 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 513629 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 513629 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14440 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 14440 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13646763 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10747797 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2898966 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05710 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14174832 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10747797 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3427035 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06750 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21867329 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15382386 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6484943 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12770 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,195,787 | BadDebtExpenseAmount |
| Amount Attributable To | 145316 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 19944118 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 19750667 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 193451 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERWOOD HEALTHCARE CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BUNKER HILL DRIVE | AddressLine1 |
| City | AITKIN | City |
| State | MN | State |
| ZIP Code | 56431 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| RIVERWOOD AITKIN CLINIC | ||||
| 200 BUNKER HILL DRIVE | AITKIN | MN | 56431 | CLINIC |
| RIVERWOOD MCGREGOR CLINIC | ||||
| 2 E CENTRAL AVENUE | AITKIN | MN | 56431 | CLINIC |
| RIVERWOOD GARRISON CLINIC | ||||
| 27278 STATE HWY 18 | GARRISON | MN | 56450 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| 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 2013 MEDICARE COST REPORT. | ||
| PART I, LINE 7G: THE HOSPITAL'S SUBSIDIZED HEALTH SERVICES INCLUDE CARDIAC REHABILITATION, DIABETES EDUCATION, NUTRITION SERVICES, EMERGENCY ROOM SERVICES, OCCUPATIONAL THERAPY SERVICES, SPEECH PATHOLOGY, LABOR AND DELIVERY ROOM SERVICES, OBSERVATION BED SERVICES, SPECIALTY CLINIC, PHYSICAL THERAPY, AND RURAL HEALTH CLINIC/RETAIL PHARMACY. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS $1,195,787. | ||
| PART II: N/A | ||
| PART III, LINE 4: FROM FOOTNOTE 1 OF THE AUDITED FINANCIAL STATEMENTS - "ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."THE TAXPAYER LOOKED AT THE NUMBER OF CHARITY CARE APPLICATIONS SENT TO POTENTIAL APPLICANTS AND CAME UP WITH AN APPROVAL RATIO BASED ON RETURNED APPLICATIONS. THEN THE RATIO WAS MULTIPLIED BY THE APPLICATIONS THAT WERE NOT RETURNED TO DETERMINE AN ESTIMATED AMOUNT OF ADDITIONAL APPROVALS. AN AVERAGE CHARITY CARE AMOUNT PER PATIENT WAS THEN ESTIMATED. THAT ESTIMATE MULTIPLIED BY THE NUMBER OF APPLICATIONS WAS USED TO DETERMINE THE BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE CHARITY CARE POLICY. | ||
| 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 $620,206 AND ALLOWABLE COSTS OF $1,104,562 RESULTING IN A SHORTFALL OF $484,356. THE SHORTFALL IS THE RESULT OF UNREIMBURSED PROFESSIONAL CARE.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 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. 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. | ||
| PART V, SECTION B, LINE 3: RIVERWOOD HEALTHCARE CENTER UTILIZED AND ENGAGED MANY INDIVIDUALS AND ORGANIZATIONS TO COMPLETE ITS CHNA. A PROJECT CORE TEAM PROVIDED INPUT AND GUIDANCE IN THIS PROJECT. THE TEAM CONSISTED OF INDIVIDUALS FROM AITKIN COUNTY PUBLIC HEALTH, AITKIN AND MCGREGOR SCHOOL DISTRICTS, AICOTA HEALTHCARE CENTER AND RIVERWOOD HEALTHCARE CENTER ALONG WITH CONSULTING FROM HBH ASSOCIATES, SHELLI URNESS CONSULTING AND HEALTH PLANNING AND MANAGEMENT RESOURCES. FEEDBACK WAS GATHERED FROM COMMUNITY MEMBER'S FROM RIVERWOOD'S PRIMARY SERVICE COMMUNITIES OF AITKIN, GARRISON AND MCGREGOR. COMMUNITY FEEDBACK SESSIONS, TELEPHONE INTERVIEWS AND EMAIL QUESTIONNAIRES WERE USED TO OBTAIN INPUT. | AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE | |
| PART V, SECTION B, LINE 14G: THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE LOBBY, ADVERTISED IN THE LOCAL NEWSPAPER AND ADVERTISED ON THE RADIO STATION. | AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE | |
| 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. ADDITIONALLY, WE PERFORM A COMMUNITY PERCEPTION ASSESSMENT AND HEALTH ASSESSMENT OF OUR SERVICE AREA EVERY 3 YEARS. | ||
| 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 CERTIFED BY THE STATE OF MINNESOTA.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. | ||
| 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 | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFF EHNSTROM MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | 293936 | 0 | 7150 | 0 | 0 | 0 | 10000 | 0 | 17822 | 0 | 328908 | 0 | 0 | 0 |
| MARK HEGGEM MD | ||||||||||||||
| CMO/DIRECTOR | 269184 | 0 | 2615 | 0 | 0 | 0 | 10000 | 0 | 17822 | 0 | 299621 | 0 | 0 | 0 |
| MICHAEL HAGEN | ||||||||||||||
| CEO - FORMER | 272177 | 0 | 10102 | 0 | 0 | 0 | 10000 | 0 | 23822 | 0 | 316101 | 0 | 0 | 0 |
| STEVEN PITSCHKA MD | ||||||||||||||
| PHYSICIAN | 316955 | 0 | 30199 | 0 | 0 | 0 | 10000 | 0 | 9228 | 0 | 366382 | 0 | 0 | 0 |
| JEFFREY RAPP MD | ||||||||||||||
| PHYSICIAN | 317595 | 0 | 26134 | 0 | 0 | 0 | 10000 | 0 | 17822 | 0 | 371551 | 0 | 0 | 0 |
| JIM HARRIS MD | ||||||||||||||
| ER MEDICAL DIRECTOR | 311991 | 0 | 0 | 0 | 0 | 0 | 10000 | 0 | 17822 | 0 | 339813 | 0 | 0 | 0 |
| DAVID TAYLOR MD | ||||||||||||||
| PHYSICIAN | 303245 | 0 | 0 | 0 | 0 | 0 | 10000 | 0 | 9228 | 0 | 322473 | 0 | 0 | 0 |
| THOMAS OSBORNE MD | ||||||||||||||
| PHYSICIAN | 329683 | 0 | 0 | 0 | 0 | 0 | 10000 | 0 | 17822 | 0 | 357505 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF AITKIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416004918 | IssuerEIN |
| CUSIP Number | 00958PAP1 | CUSIPNumber |
| Date Issued | 2006-08-10 | DateIssued |
| Issue Price | 24350057 | IssuePrice |
| Description Of Purpose | REFINANCE 2001 BONDS THAT WERE USED TO BUILD NEW HOSPITAL | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 24350057 | TotalProceeds |
| Issuance Costs From Proceeds | 487001 | IssuanceCostsFromProceeds |
| Year Of Subst Completion | 2006 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 | 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 RHCCS 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 15 | HEALTHCARE COMPENSATION SURVEYS ARE USED FOR COMPARABLE DATA AND RECOMMENDATIONS. INTERNAL PERFORMANCE EVALUATIONS ALSO HAVE AN EFFECT ON COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 18 | INFORMATION IS AVAILABLE UPON REQUEST. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ANNUAL REPORT, WHICH PROVIDES AN OVERVIEW OF THE ORGANIZATIONS FINANCIAL STATUS, IS MADE AVAILABLE TO THE PUBLIC. IT IS MAILED TO MEMBERS OF THE ORGANIZATION, ORGANIZATIONS THAT WE HAVE FINANCING WITH, AND IS AVAILABLE ON OUR WEBSITE. THE OTHER DOCUMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. | |
| FORM 990, PART VII, SECTION A | JEFF EHNSTROM, MD: RIVERWOOD HEALTHCARE CENTER TIME ALLOCATION: EMPLOYMENT AS A DOCTOR: 40 HOURS PER WEEK BOARD OF DIRECTORS: 1 HOURS PER WEEK RIVERWOOD HEALTHCARE ASSOCIATION COMPENSATION: DOCTOR REPORTABLE COMPENSATION: $ 301,086 DOCTOR OTHER COMPENSATION: $ 27,822 BOARD REPORTABLE COMPENSATION: $ 0 BOARD OTHER COMPENSATION: $ 0 MARK HEGGEM, MD: RIVERWOOD HEALTHCARE CENTER TIME ALLOCATION: EMPLOYMENT AS A DOCTOR: 40 HOURS PER WEEK BOARD OF DIRECTORS: 1 HOURS PER WEEK RIVERWOOD HEALTHCARE ASSOCIATION COMPENSATION: DOCTOR REPORTABLE COMPENSATION: $ 271,799 DOCTOR OTHER COMPENSATION: $ 27,822 BOARD REPORTABLE COMPENSATION: $ 0 BOARD OTHER COMPENSATION: $ 0 MICHAEL HAGEN HOURS PER WEEK DEVOTED TO THE HOSPITAL = 39.9 HOURS PER WEEK DEVOTED TO THE FOUNDATION (RELATED ORGANIZATION) = 0.1 ALL COMPENSATION RECEIVED IS FOR MICHAEL'S POSITION AS THE HOSPITAL CEO. KENT DUMONSEAU HOURS PER WEEK DEVOTED TO THE HOSPITAL = 39.9 HOURS PER WEEK DEVOTED TO THE FOUNDATION(RELATED ORGANIZATION) = 0.1 ALL COMPENSATION RECEIVED IS FOR KENT'S POSITION AS THE FORMER HOSPITAL CFO. GORDY FORBORT HOURS PER WEEK DEVOTED TO THE HOSPITAL = 39.9 HOURS PER WEEK DEVOTED TO THE FOUNDATION (RELATED ORGANIZATION) = 0.1 ALL COMPENSATION RECEIVED IS FOR GORDY'S POSITION AS THE HOSPITAL INTERIM CFO. | |
| FORM 990, PART XI, LINE 9: | DECREASE IN INTEREST IN NET ASSETS OF AITKIN COMMUNITY HOSPITAL FOUNDATION -156,308. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERWOOD HEALTH CARE CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BUNKER HILL DRIVE | AddressLine1 |
| City | AITKIN | City |
| State | MN | State |
| ZIP Code | 56431 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411738787 | EIN |
| Primary Activities | SUPPORT | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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