2026-08-14T11:49:26-05:00 2025-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2024-10-01 410745522 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER AITK 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 CASEY JOHNSON CFO 2189272121 2026-08-13 1 1 JULIE BOYER P01278549 2187275025 2026-08-13 2024 2025-03-06 01:10:19Z KEN WESTMAN 200 BUNKER HILL DRIVE AITKIN MN 56431 122400723 0 X WWW.RIVERWOODHEALTHCARE.ORG X 1948 MN RIVERWOOD HEALTHCARE CENTER'S MISSION IS TO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. COUPLING THIS WITH OUR VISION OF BEING THE REGION'S PREFERRED HEALTH SYSTEM PROVIDING EXCEPTIONAL CARE AND OUR VALUES OF INTEGRITY, CUSTOMER SERVICE, UNITY, RESPECT, COMPASSION, EXCELLENCE AND PASSION WE FOCUSED ON SIX STRATEGIC GOALS. THESE SIX PILLARS ARE PEOPLE, CUSTOMER SERVICE, GROWTH, COMMUNITY, STEWARDSHIP AND QUALITY. WE STRIVE FOR THESE IN ALL THAT WE DO FOR OUR PATIENTS. 11 10 600 101 1354085 27390 683121 5315623 101971501 110405442 665989 1670967 1305826 3536259 104626437 120928291 184072 96748 0 0 48027830 51691355 0 0 0 58661333 71499611 106873235 123287714 -2246798 -2359423 172276125 157459903 96324782 94067392 75951343 63392511 X TO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 0 0 98783915 96748 113588656 RIVERWOOD HEALTHCARE CENTER'S MISSION IS TO IMPROVE HEALTH BY PROVIDING HIGH-QUALITY, COMPASSIONATE, AND PERSONALIZED CARE. COUPLED WITH ITS VISION OF BEING THE REGION'S PREFERRED HEALTH SYSTEM PROVIDING EXCEPTIONAL CARE, AND ITS VALUES OF INTEGRITY, COMPASSION, ADAPTABILITY, RESPECT, AND EXCELLENCE WITH JOY, RIVERWOOD HEALTHCARE CENTER IS DEDICATED TO ADDRESSING ITS OUTREACH OBJECTIVES BY SERVING THE ENTIRE COMMUNITY, NOT ONLY THOSE WHO COME THROUGH ITS DOORS. BUILDING ON A LONG TRADITION OF PROVIDING HIGH-QUALITY, COMPASSIONATE, AND PERSONALIZED CARE, RIVERWOOD IS COMMITTED TO CARING FOR THOSE WITHIN THE HEALTHCARE SYSTEM AND WORKING WITH COMMUNITY PARTNERS TO STRENGTHEN THE COMMUNITIES IT SERVES. CONTINUED ON SCHEDULE O.THIS STRATEGY ALLOWS RIVERWOOD HEALTHCARE CENTER TO BETTER UNDERSTAND AND REACH THE MOST VULNERABLE SECTORS OF THE COMMUNITY WHILE MEETING PRESSING HEALTHCARE NEEDS. THE GOAL IS TO IMPROVE THE COMMUNITY'S HEALTH STATUS BY EMPOWERING CITIZENS TO MAKE HEALTHY LIFE CHOICES.RIVERWOOD CONNECTS IS A COMMUNITY HEALTH INITIATIVE THAT PROVIDES A CENTRAL PLATFORM FOR RESOURCES ADDRESSING SOCIAL INFLUENCERS OF HEALTH, SUCH AS FOOD INSECURITY, HOUSING, AND TRANSPORTATION. RIVERWOOD ADDS PATIENTS TO THE PLATFORM TO ENSURE THEY CAN ACCESS THE RESOURCES THEY NEED AND PARTNERS WITH AITKIN COUNTY CARE TO ENSURE RESOURCES ARE DISTRIBUTED EFFECTIVELY. RIVERWOOD CONNECTS USES FIND HELP AND FOOD RX. FIND HELP IS A COLLABORATIVE EFFORT DERIVED FROM THE 2020 NEEDS ASSESSMENT COMPLETED BY THE AITKIN COUNTY COALITION, LED BY AITKIN COUNTY CARE. THE ASSESSMENT IDENTIFIED THE NEED FOR A COMMUNITY RESOURCE HUB, WITH FIND HELP SELECTED AS THE ONLINE HUB OF CHOICE. FIND HELP WAS BUILT IN 2010 TO OFFER AN EASIER WAY TO FIND SOCIAL SERVICES AND CONNECT TO THEM DIRECTLY AND ELECTRONICALLY. WITH FINANCIAL AND ADMINISTRATIVE ASSISTANCE FROM AITKIN COUNTY CARE, RIVERWOOD IMPLEMENTED FIND HELP IN ITS FACILITY AND COMMUNITYWIDE. AITKIN COUNTY CARE WAS INSTRUMENTAL IN ASSISTING WITH COMMUNITY OUTREACH TO ORGANIZATIONS ONBOARDING WITH FIND HELP. BY USING DATA ANALYTICS WITH BOTH THE ELECTRONIC HEALTH RECORD AND FIND HELP, RIVERWOOD HAS BEEN ABLE TO ADDRESS PATIENTS' SOCIAL DETERMINANTS OF HEALTH AND CONNECT THEM TO RESOURCES. ONE OF THE KEY RESOURCES PROVIDED THROUGH THE RIVERWOOD CONNECTS PROGRAM IS ACCESS TO NUTRITIOUS FOOD. THE FOOD RX PROGRAM EMPHASIZES THE ROLE HEALTHY FOOD PLAYS IN OVERALL HEALTH AND ELIMINATES BARRIERS, SUCH AS BUDGET AND TRANSPORTATION, TO ACCESSING FOOD. IN PARTNERSHIP WITH LOCAL FARMERS, THE AITKIN FARMERS MARKET HUB, AND THE AITKIN COUNTY STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP, PARTICIPANTS ARE PROVIDED COMMUNITY SUPPORTED AGRICULTURE SHARES AND "RIVERWOOD CONNECTS BUCKS" TO USE AT THE AITKIN FARMERS MARKET. BY PROVIDING EQUITABLE ACCESS TO NUTRITIOUS FOOD AND COMMUNITY RESOURCES, RIVERWOOD IS TAKING STEPS TO MAKE THE COMMUNITIES IT SERVES HEALTHIER. RIVERWOOD HEALTHCARE CENTER, WITH THE HELP OF THE AITKIN FARMERS MARKET HUB AND AITKIN COUNTY PUBLIC HEALTH, WAS AWARDED THE MINNESOTA LOCAL FOOD PURCHASE ASSISTANCE (LFPA) GRANT BY THE MINNESOTA DEPARTMENT OF AGRICULTURE (MDA). THE LFPA PROGRAM IS A CONTINUING GRANT FROM MDA TO FUND PROJECTS THAT BUY LOCAL FOOD, PRIMARILY FROM SOCIALLY DISADVANTAGED AND EMERGING FARMERS, AND DISTRIBUTE IT TO UNDERSERVED COMMUNITIES. RIVERWOOD PARTNERS WITH AITKIN COUNTY CARE AND ANGELS OF MCGREGOR TO DISBURSE BOXES THROUGHOUT THE COUNTY. BOXES ARE PROVIDED TO EACH ORGANIZATION, AND THEY DISTRIBUTE THE FOOD TO THOSE THEY HAVE IDENTIFIED AS AT RISK OR FOOD INSECURE. RIVERWOOD PROVIDES ADMINISTRATION OF THE GRANT, ALONG WITH OUTREACH EFFORTS WITHIN THE COMMUNITIES OF AITKIN COUNTY. EACH MONTH, AREAS ARE IDENTIFIED THROUGH AITKIN COUNTY CARE AND ANGELS. FOOD BOXES WERE DISTRIBUTED IN MCGRATH, MCGREGOR, AND PALISADE, MINNESOTA. RIVERWOOD, AITKIN COUNTY PUBLIC HEALTH'S STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP (SHIP), THE AITKIN FARMERS MARKET HUB, CARE, AND ANGELS COORDINATE TO DISCUSS THE AREA OF HIGHEST NEED AND THE NEXT LOCATION TO TARGET WITH FOOD BOXES FOR SENIORS. THE FOOD PROGRAM IS OFFERED UNDER RIVERWOOD'S CONNECTS COMMUNITY OUTREACH UMBRELLA, ALONG WITH FIND HELP AND FOOD RX. TOGETHER WITH COMMUNITY PARTNERS, RIVERWOOD IS STRIVING TO ADDRESS HUNGER AND IMPROVE HEALTH FOR LOCAL COMMUNITY MEMBERS.RIVERWOOD HEALTHCARE CENTER HAS EARNED PRESTIGIOUS AWARDS EACH YEAR, DEMONSTRATING THE QUALITY OF SERVICES RIVERWOOD'S EMPLOYEES PROVIDE TO THE COMMUNITY. AWARDS INCLUDE THE TOP 5 CRITICAL ACCESS HOSPITAL AWARD FROM THE CHARTIS CENTER FOR RURAL HEALTH, A FIVE-STAR RATING FOR CLEANLINESS FROM CMS, THE 2025 OUTSTANDING PATIENT EXPERIENCE AWARD FROM HEALTHGRADES, THE 2025 POPULATION HEALTH PIONEER AWARD FROM WELLVANA, THE 2025 QUALITY AND SAFETY IMPROVEMENT AWARD FROM MHA, CALS DESIGNATION AND ACUTE STROKE READY HOSPITAL RECERTIFICATION.CHARTIS' ANNUAL TOP 100 AWARD PROGRAM HONORS OUTSTANDING PERFORMANCE AMONG THE NATION'S RURAL HOSPITALS BASED ON THE RESULTS OF THE CHARTIS RURAL HOSPITAL PERFORMANCE INDEX. "THIS RECOGNITION IS AN INCREDIBLE HONOR AND REAFFIRMS OUR UNWAVERING DEDICATION TO DELIVERING HIGH-QUALITY HEALTHCARE TO OUR COMMUNITY WHILE ENSURING EFFICIENCY AND EXCELLENCE IN OUR OPERATIONS," SAID KEN WESTMAN, CHIEF EXECUTIVE OFFICER OF RIVERWOOD HEALTHCARE CENTER. "THE TOP 100 CRITICAL ACCESS HOSPITALS AWARD PROGRAM ELEVATES THE VERY BEST PERFORMERS AND HELPS CREATE A ROADMAP FOR THOSE SEEKING TO IMPROVE FINANCIAL AND OPERATIONAL PERFORMANCE WHILE CONTINUING TO CARE FOR THE COMMUNITIES THEY SERVE," SAID MICHAEL TOPCHIK, EXECUTIVE DIRECTOR, THE CHARTIS CENTER FOR RURAL HEALTH. "THIS IS OUR 15TH YEAR RECOGNIZING THE TOP 100 CRITICAL ACCESS HOSPITALS AND WE'RE THRILLED TO BE ABLE TO CELEBRATE THIS MILESTONE WITH THIS YEAR'S WINNERS."THE INDEX IS THE INDUSTRY'S MOST COMPREHENSIVE AND OBJECTIVE ASSESSMENT OF RURAL HOSPITAL PERFORMANCE. LEVERAGING PUBLICLY AVAILABLE DATA, THE INDEX IS UTILIZED NATIONWIDE BY RURAL HOSPITALS, HEALTH SYSTEMS WITH RURAL AFFILIATES, HOSPITAL ASSOCIATIONS, AND STATE OFFICES OF RURAL HEALTH TO MEASURE AND MONITOR PERFORMANCE ACROSS A VARIETY OF AREAS IMPACTING HOSPITAL OPERATIONS AND FINANCE.THE CHARTIS CENTER FOR RURAL HEALTH COMPILES THESE RANKINGS, WHICH RATE THE 1,300 RURAL 25-BED HOSPITALS ON EIGHT INDICES OF STRENGTH: QUALITY, OUTCOMES, PATIENT PERSPECTIVES, COST, CHARGE AND FINANCIAL STABILITY, INPATIENT MARKET SHARE, AND OUTPATIENT MARKET SHARE. RIVERWOOD HEALTHCARE CENTER STRIVES TO DELIVER THE HIGHEST QUALITY PATIENT-CENTERED CARE. WE CONTINUALLY EXAMINE THE 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 ABOUT HEALTH ISSUES. THE COMMUNITY'S AND PATIENTS' NEEDS ARE HEARD AND INCORPORATED INTO OUR MISSION STATEMENT, STRATEGIC PLAN, AND VISION.RIVERWOOD HEALTHCARE CENTER EARNED A FIVE-STAR RATING FOR CLEANLINESS FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES. THIS REPORT IS BASED ON PATIENT SATISFACTION SURVEYS ISSUED AND COMPILED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS), A NATIONAL, STANDARDIZED SURVEY OF HOSPITAL PATIENTS ABOUT THEIR EXPERIENCES DURING RECENT INPATIENT STAYS. THE SURVEYS WERE COMPLETED BETWEEN APRIL 1, 2023, AND MARCH 31, 2024. CHIEF OPERATING OFFICER CINDI BAKER COMMENTED, "WE ARE HONORED TO RECEIVE THIS TOP-TIER CLEANLINESS RATING ONCE AGAIN AFTER RECEIVING IT IN 2024. THIS ACHIEVEMENT WAS MADE POSSIBLE BY THE DEDICATION AND ATTENTION TO DETAIL OF OUR ENVIRONMENTAL SERVICES TEAM. EVERY DAY, THIS TEAM WORKS TIRELESSLY TO ENSURE THAT OUR HOSPITAL ENVIRONMENT IS NOT ONLY CLEAN BUT ALSO SAFE, WELCOMING, AND COMFORTABLE FOR EVERY PATIENT, VISITOR, AND STAFF MEMBER." THE SURVEY IS GIVEN TO A RANDOM SAMPLE OF ADULT PATIENTS BETWEEN 2 AND 42 DAYS AFTER DISCHARGE AND INCLUDES 27 ITEMS, INCLUDING CLEANLINESS AND QUIETNESS OF THE HOSPITAL ENVIRONMENT. THE RESULTS ARE PUBLISHED ON THE CARE COMPARE WEBSITE FOUR TIMES A YEAR. THE OVERALL HCAHPS SUMMARY SCORE IS ON A FIVE-STAR RATING SCALE, WITH FOUR- AND FIVE-STAR RATINGS BEING THE BEST. 98783915 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 80 0 1 600 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X JUDY TURNER 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 DR JEFFREY EHNSTROM DIRECTOR/PHYSICIAN 40.00 0.00 X 444052 0 60196 DR TIMOTHY DIRKS DIRECTOR 1.00 0.00 X 0 0 0 HEATHER HIPP DIRECTOR 1.00 0.00 X 0 0 0 TOM LUNDBERG DIRECTOR 1.00 0.00 X 0 0 0 JARED LUNDGREN DIRECTOR 1.00 0.00 X 0 0 0 BRYAN NISTLER DIRECTOR 1.00 0.00 X 0 0 0 STEVE WILSON DIRECTOR 1.00 0.00 X 0 0 0 KATHLEEN RYAN CHAIR 1.00 0.00 X X 0 0 0 CHRISTINE BRIGHT VICE CHAIR 1.00 0.00 X X 0 0 0 CHAD GROSS TREASURER 1.00 0.00 X X 0 0 0 LOWELL LARSON SECRETARY 1.00 0.00 X X 0 0 0 KEN WESTMAN CEO 38.00 2.00 X 552849 0 53468 CASEY JOHNSON CFO 38.00 2.00 X 268928 0 48517 DR DAVID TAYLOR CMO 40.00 0.00 X 630679 0 58769 CYNTHIA BAKER COO 38.00 2.00 X 272192 0 41680 ROBERT SCHMIEG CRNA 40.00 0.00 X 448647 0 54919 DR JESSICA HODSON ER PHYSICIAN 40.00 0.00 X 435314 0 60766 DR JIM HARRIS ER PHYSICIAN 40.00 0.00 X 405281 0 55618 JANELLE TEPPER CRNA 40.00 0.00 X 392622 0 58388 DONALD HUGHES PHYSICIAN 40.00 0.00 X 371020 0 53730 4221584 0 546051 92 0 1 0 CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN ST CROSBY MN 56441 MEDICAL/SURGICAL PROF SVCS 4738100 CENTRAL MINNESOTA DIAGNOSTICS INC 150 10TH ST MILACA MN 56353 RADIOLOGY PROF SVCS 1792531 PREMIER SURGICAL ASSOCIATES PA 318 E MAIN ST CROSBY MN 56441 MEDICAL PROF SVCS 1300279 MEDICAL SOLUTIONS LLC 1010 N 102ND ST 300 OMAHA NE 68114 HOURLY LABOR 1140253 REGIONAL DIAGNOSTIC RADIOLOGY 1990 CONNECTICUT AVE S SARTELL MN 56377 RADIOLOGY PROF SVCS 677790 22 5034755 121933 158935 5315623 NET PATIENT SERVICE RE 621500 109051357 109051357 RETAIL PHARMACY 456110 1354085 1354085 110405442 1336119 1336119 1632728 174552 1472432 0 160296 174552 334848 334848 OTHER REVENUE 900099 952662 952662 EQUITY IN EARNINGS OF 900099 580293 580293 CAFETERIA 900099 353045 353045 1650259 1650259 3536259 120928291 112234571 1354085 2024012 X 92748 92748 4000 4000 2326923 531804 1795119 37292780 32770919 4521861 1361943 261431 1100512 8075696 1560857 6514839 2634013 509406 2124607 62544 62544 320287 320287 57512 57512 21765276 19768919 1996357 75383 75383 2420146 1764866 655280 147 147 1346389 1277474 68915 76933 67339 9594 55268 43702 11566 3311715 2651388 660327 9040452 7768665 1271787 535974 535974 UBTI 1600 1600 DRUGS 16684919 16684919 MEDICAL SUPPLIES 9706483 9531437 175046 REPAIRS & MAINTENANCE 1669813 1619238 50575 4368770 1874803 2493967 123287714 98783915 24503799 0 9283190 798731 18891363 16699653 4782618 4680790 760503 794028 168685741 71578865 94444383 97106876 6732748 11950278 424348 303106 36956972 25126441 172276125 157459903 13929779 13611798 55739090 53410775 22148022 21627424 4507891 5417395 96324782 94067392 X 69461080 62139557 6490263 1252954 75951343 63392511 172276125 157459903 X -2359423 293864 -196651 -5919555 -4377067 X X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 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. 636270 0 49105 8400 50000 626975 572223 600 117235 8000 45788 636270 536857 50366 15000 572223 656179 8000 -111322 16000 536857 593667 77512 15000 656179 0.13734 0.43117 0.43149 0 1 1 1669923 1669923 98169487 33633274 64536213 1143461 320972 822489 55156188 33215378 21940810 12546682 4409241 8137441 97106876 ASSETS LIMITED FOR RESERVE ACCOUNTS 7475387 ASSETS LIMITED BY BOARD FOR FUNDED 4246790 ASSETS LIMITED BY AGREEMENT FOR DEF 3770827 INVESTMENTS IN CENTRAL MINNESOTA DI 1723180 LEASE RIGHT-OF-USE ASSET 5387778 DUE FROM MEDICARE 2223759 INTEREST RATE SWAP 298720 25126441 OPERATING LEASE LIABILITY 5417395 5417395 116053151 293864 -5092470 -4798606 120851757 57512 19022 76534 120928291 122175602 196651 -1232229 -1035578 123211180 57512 19022 76534 123287714 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 XI, LINE 2D - OTHER ADJUSTMENTS: DECREASE IN INTEREST IN NET ASSETS - RIVERWOOD FOUNDATION -5,237,309. RIVERWOOD MEDICAL PROPERTIES, LLC REVENUE 6,305,000. ELIMINATIONS RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -5,549,292. UNREALIZED GAIN/LOSS ON INTEREST RATE SWAPS 726,223. IMPLICIT PRICE CONCESSIONS -1,337,092. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE NETTED WITH REVENUE 19,022. PART XII, LINE 2D - OTHER ADJUSTMENTS: RIVERWOOD MEDICAL PROPERTIES, LLC EXPENSES 4,003,896. ELIMINATION RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -3,899,033. IMPLICIT PRICE CONCESSIONS -1,337,092. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE NETTED WITH REVENUE 19,022. 1 1 X 1 X 1 X 1 1 0 1 1 1310733 1310733 0.01070 13623554 10240606 3382948 0.02770 14934287 10240606 4693681 0.03840 692429 692429 0.00570 18925 18925 0.00020 711354 711354 0.00590 15645641 10240606 5405035 0.04430 1 1337092 X 1 1 1 1 RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN MN 56431 HTTPS://RIVERWOODHEALTHCARE.ORG/ 414977 X X X X N/A AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, PAGE 8 X 1 24 1 SEE PART V, PAGE 8 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART V, SECTION B, LINE 5: RIVERWOOD HEALTHCARE CENTER SOUGHT INPUT FROM KEY INFORMANTS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. IN ORDER TO DO THIS, RIVERWOOD PROVIDED A LIST OF RECOMMENDED PARTICIPANTS TO THE INDEPENDENT VENDOR, PROFESSIONAL RESEARCH CONSULTANTS, INC (PRC). THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS THEY WORK WITH AS WELL AS THE OVERALL COMMUNITY. OF THE INITIAL RECOMMENDED LIST, 56 PEOPLE PARTICIPATED AS COMMUNITY STAKEHOLDERS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART V, SECTION B, LINE 11: THE MISSION OF RIVERWOOD HEALTHCARE CENTER IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. THE IMPLEMENTATION STRATEGY IS DESIGNED TO ADDRESS THE HEALTH CARE NEEDS OF THE PEOPLE IN AITKIN COUNTY AND THEIR UNIQUE CHARACTERISTICS. THE IMPLEMENTATION STRATEGIES ARE BASED ON RIVERWOOD'S CURRENT PROGRAMMING, SURVEY DATA AND COMMUNITY INPUT. RIVERWOOD'S STRATEGIC PLAN IS DEVELOPED BY ITS LEADERSHIP TEAM AND REVIEWED ANNUALLY. THE IMPLEMENTATION STRATEGY ALSO IDENTIFIES HOW EXISTING AND PLANNED RIVERWOOD SERVICES, PARTNERSHIPS AND PROGRAMS WILL BE UTILIZED TO HELP ADDRESS COMMUNITY HEALTH NEEDS.THE IMPLEMENTATION STRATEGY FOR THE HEALTH OF AITKIN COUNTY IS THE HOSPITAL/COMMUNITY PLAN FOR ADDRESSING THE COMMUNITY HEALTH NEEDS. THE IRS DICTATES THE CONTENTS OF AN IMPLEMENTATION STRATEGY AND STATES THAT THE HOSPITAL MUST ADDRESS HOW IT BOTH INTENDS AND DOES NOT INTEND TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. RIVERWOOD'S IMPLEMENTATION STRATEGY IS DESCRIBED IN THIS SECTION OF THE REPORT. ADDRESSING OUR COMMUNITY'S NEEDS WILL BE ACCOMPLISHED BY SUSTAINING EFFORTS OPERATING WITHIN A TARGETED HEALTH PRIORITY AREA, DEVELOPING LATEST PROGRAMS AND INITIATIVES TO ADDRESS IDENTIFIED HEALTH NEEDS AND PROMOTE AND UNDERSTAND THESE NEEDS. WE WILL CONTINUE TO STAY THE COURSE AND FOLLOW OUR STRATEGIC PLAN. WE WILL CREATE THE FUTURE WE SEEK BY FOCUSING ON THREE STRATEGIC GOALS.1) SUSTAINING EFFORTS OPERATING WITHIN A TARGETED HEALTH PRIORITY AREA;2) DEVELOPING NEW PROGRAMS AND INITIATIVES TO ADDRESS IDENTIFIED HEALTH NEEDS; AND/OR 3) PROMOTING AN UNDERSTANDING OF THESE HEALTH NEEDS AMONG OTHER COMMUNITY ORGANIZATIONS AND WITHIN THE PUBLIC ITSELF.PRIORITY HEALTH ISSUES RIVERWOOD WILL ADDRESS:IN CONSIDERATION OF THE TOP HEALTH PRIORITIES IDENTIFIED THRU THE CHNA PROCESS, AND CONSIDERING HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION STATEMENT, GOALS, AND STRATEGIC PRIORITIES, IT WAS DETERMINED THAT RIVERWOOD WILL FOCUS ON DEVELOPING AND/OR SUPPORTING THESE STRATEGIES AND INITIATIVES TO IMPROVE:1) MENTAL HEALTH 2) HEART DISEASE & STROKE 3) NUTRITION, PHYSICAL ACTIVITY AND WEIGHTISSUES THAT RIVERWOOD WILL NOT ADDRESS INCLUDE: DISABLING CONDITIONS, INJURY & VIOLENCE PREVENTION, CANCER, ORAL HEALTH, AND RESPIRATORY DISEASE. LIMITED RESOURCES EXCLUDED CANCER, ORAL HEALTH, DISABLING CONDITIONS AND RESPIRATORY DISEASE AS AREAS CHOSEN FOR ACTION AT THIS TIME. RIVERWOOD FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE HEALTH CARE SERVICES WILL ALSO HAVE A POSITIVE IMPACT IN THESE AREAS. AS FOR INJURY AND VIOLENCE, RIVERWOOD BELIEVES THAT THIS PRIORITY AREA FALLS WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.CONCLUSION:IN ADDITION TO SPECIFIC STRATEGIES AND MISSION DRIVEN PROGRAMS, RIVERWOOD CONTINUES TO MAINTAIN ITS HEALTH CARE HOME CERTIFICATION USING A TEAM-BASED APPROACH TO ADDRESS SOCIAL DETERMINATES OF HEALTH AND PATIENT NEEDS. EXPANDING THE ROLE OF MENTAL HEALTH RN THROUGH BEHAVIORAL HEALTH INTEGRATION WILL SUPPORT THE PROVIDER AND PROVIDE CARE COORDINATION FOR PATIENTS TO ASSIST THEM IN CONNECTING WITH APPROPRIATE COMMUNITY RESOURCES. BEHAVIORAL HEALTH SERVICE WILL BE BROUGHT ON TO THE MAIN CAMPUS TO ALLOW FOR CONTINUITY OF CARE AND HAVE EASY ACCESSIBILITY TO EMERGENCY ROOMS AND INPATIENTS NEEDING SERVICES. WE HAVE COLLABORATED WITH A COMMUNITY WIDE TASKFORCE TO INCREASE MENTAL HEALTH AWARENESS. THE GOAL IS TO REDUCE AVOIDABLE ED ADMISSIONS DUE TO MENTAL HEALTH CONCERNS. RIVERWOOD PARTNERS WITH AITKIN COUNTY COMMITTEE FOR THE AWARENESS AND PREVENTION OF SUICIDE (CAPS) TO BRING SUICIDE PREVENTION AWARENESS TO SCHOOL STUDENTS IN THE COUNTY AS WELL AS TO THE PUBLIC. EVENTS INCLUDED SCREENINGS, PANEL DISCUSSIONS AND CONVERSATIONS TO HELP SPREAD HOPE AND FIGHT SUICIDE THROUGHOUT AITKIN COUNTY. IN CONJUNCTION WITH PUBLIC HEALTH, RIVERWOOD IS WORKING TO DEVELOP PROGRAMS TO INCREASE AWARENESS OF DEPRESSION AND SUICIDE SINCE WE ARE SEEING INCREASED RATES IN GENERAL BUT ESPECIALLY AMONG TEENS. IN DIRECT CORRELATION WITH MENTAL HEALTH IS THE OPIOID ADDICTION CRISIS. RIVERWOOD HAS WORKED WITH THE MINNESOTA DEPARTMENT OF HEALTH IN SECURING OPIOID PREVENTION AND TREATMENT GRANTS. THESE GRANTS HELP FUND A MULTIDISCIPLINARY CONTROLLED SUBSTANCE CARE TEAM THAT CONTINUES TO PROVIDE MONTHLY OVERSIGHT TO ALL CLINIC LOCATIONS TO HELP INFORM AND EDUCATE COMMUNITY MEMBERS ABOUT SUBSTANCE ABUSE. THIS GROUP COLLABORATES WITH A LARGER PARTNERSHIP OF LOCAL AND REGIONAL HEALTH SYSTEMS, CITY AND COUNTY LAW ENFORCEMENT, AITKIN COUNTY HEALTH AND HUMAN SERVICES, AREA SCHOOL DISTRICTS AND THE MINNESOTA DEPARTMENT OF HEALTH TO TEACH BEST PRACTICES AND EDUCATE COMMUNITY MEMBERS ABOUT SUBSTANCE ABUSE, PREVENTION, AND TREATMENT. THE GOAL HERE IS TO REDUCE BOTH INAPPROPRIATE USE OF OPIOIDS BY PATIENTS AND RATES OF OPIOID ADDICTION BY INCREASING COMMUNITY WIDE AWARENESS. FOR THE AREAS OF NUTRITION, ACTIVITY, WEIGHT, AND DIABETES, RIVERWOOD PARTNERS WITH COMMUNITY EDUCATION THROUGH AITKIN AND MCGREGOR SCHOOLS AND AITKIN COUNTY PUBLIC HEALTH TO ENCOURAGE THE HEALTH AND WELLNESS OF OUR COMMUNITIES. EDUCATION ON PREVENTION AND OFFERING SUPPORT, MANAGEMENT PROGRAMS AND COMMUNITY RESOURCES SUPPORTS THE HEALTH AND WELL-BEING OF OUR POPULATION. THE PROGRAM OF LIVING WELL WITH CHRONIC CONDITIONS IS OFFERED TO RESIDENTS OF AITKIN COUNTY. A COMMUNITY WELLNESS RESOURCE GUIDE IS MAINTAINED BY RIVERWOOD AND IS AVAILABLE TO ALL PATIENTS AND COMMUNITY MEMBERS. RIVERWOOD CONTINUES TO SUPPORT A HEALTHY COMMUNITY BY PARTICIPATING IN HEALTH FAIRS, COMMUNITY WALKS/RUNS AND PROMOTING VOLUNTEERISM. REGULARLY PROVIDED REGISTERED DIETITIAN HEALTHY EATING TIPS AND RECIPES ARE AVAILABLE TO THE COMMUNITY ON OUR WEBSITE. IN CONJUNCTION WITH USDA FEDERAL FUNDED MINNESOTA DEPARTMENT OF HEALTH GUSNIP GRANT, RIVERWOOD IS IMPLEMENTING THE FOOD RX PROGRAM WHICH WILL HELP CLOSE THE GAP WITH FOOD INSECURITY. GUSNIP FRESH PRODUCE PRESCRIPTIONS BRING TOGETHER PARTNERS FROM THE FOOD AND HEALTHCARE SYSTEM TO ASSIST LOW-INCOME FAMILIES BY INCREASING PURCHASING POWER AND ACCESS TO FRESH FRUITS AND VEGETABLES. THIS PROGRAM CAN ONLY BE UTILIZED ON FRESH PRODUCE, WHICH IS OFTEN EXPENSIVE IN MINNESOTA WINTERS. A COMMUNITY HEALTH BOARD-SHIP GRANT ESTABLISHED A FARM 2 RIVERWOOD PROGRAM PROVIDING FRESH PRODUCE IN THE CAFETERIA AND OPPORTUNITIES FOR THE COMMUNITY TO PURCHASE THROUGH THE AITKIN COUNTY FARMERS MARKET HUB ONLINE PLATFORM. FARMER'S MARKETS ARE HELD TO MAKE IT EASY FOR PATIENTS AND THE COMMUNITY TO ACCESS FRESH LOCAL HEALTHY FOODS. THIS IMPLEMENTATION SUPPORTS AND COLLABORATES WITH LOCAL FARMERS AND ENGAGES LOCAL GROCERS. FOR THE AREA OF HEART DISEASE AND STROKE, RIVERWOOD UTILIZES MINNESOTA COMMUNITY MEASURES AND ACCOUNTABLE CARE ORGANIZATIONS METRICS TO MEASURE PATIENT PROGRESS TOWARDS PREVENTION AND MANAGEMENT OF CHRONIC CONDITIONS. UTILIZING THESE MEASURES WITH OUR CARE MANAGEMENT TEAM, RIVERWOOD CAN HELP KEEP PATIENTS HEALTHY AND OUT OF THE HOSPITAL, CREATING SHARED SAVINGS FOR BOTH THE PATIENT AND THE FACILITY. THROUGH UTILIZATION OF SOCIAL MEDIA OUTLETS, ENEWSLETTER, OUR WEBSITE, FREE SEMINARS, AND EDUCATIONAL AWARENESS CAMPAIGNS WE PROMOTE AND INCREASE AWARENESS OF THE IMPORTANCE OF ANNUAL VISITS. NURSE CARE MANAGERS CONTACT PATIENTS TO EDUCATE THEM ON MEDICATION ADHERENCE, OFFER SMOKING SESSION PROGRAMS, AND OFFER BLOOD PRESSURE CUFFS FOR PATIENTS WITH HYPERTENSIONS ISSUES FOR AT HOME MONITORING. AS A PART OF A RECENT SURGERY EXPANSION, RIVERWOOD CREATED A RING ROAD AROUND THE ENTIRE CAMPUS SO THAT PATIENTS, VISITORS, AND THE COMMUNITY CAN HAVE A SAFE, WELL-LIT WALKING PATH AROUND THE ENTIRE CAMPUS. THE PATH CONNECTS WITH THE RIVERWOOD HEALING GARDEN WHICH CAN BE ENJOYED FOR ITS SOLACE AND FOR A TIME OF REFLECTION. RIVERWOOD BUILDS EVALUATIVE MEASURES AND GOALS INTO ALL ITS PROGRAMS AND SERVICES. IN ADDITION, THE CHNA PLAN IS REVIEWED AND REWRITTEN EVERY THREE YEARS. RIVERWOOD'S MANAGEMENT TEAM CONTINUES TO PLAY A LEADERSHIP ROLE IN THE IMPLEMENTATION OF STRATEGIES AND MONITORING ITS PROGRESS AND ADJUSTS STRATEGIES AS NEEDED. RIVERWOOD CONTINUES TO OFFER SAME DAY CLINIC TO EXPAND ACCESS TO MEDICAL CARE FOR THE COMMUNITY. BOTH FACE-TO-FACE AND VIRTUAL VISITS ARE AVAILABLE TO IMPROVE ACCESS AND HELP REDUCE WAITING TIMES.SEE PART V, PAGE 8 FOR CONTINUATION AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE PART V, SECTION B, LINE 16J: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO IS AVAILABLE TO TALK WITH ANY PATIENT WHO FEELS THEY MAY HAVE DIFFICULTY PAYING THEIR BILL. SHE IS A TRAINED MNSURE NAVIGATOR AND CAN ASSIST ANYONE WITH CHECKING TO SEE IF THEY QUALIFY FOR MEDICAL ASSISTANCE, MNCARE OR IF THEY COULD PURCHASE AN INSURANCE. SHE OFFERS INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) AND CAN ANSWER ANY QUESTIONS ON APPLYING FOR AND GETTING COMMUNITY CARE THROUGH THE HOSPITAL. ALL THE HOSPITAL'S PATIENT ACCOUNTS REPRESENTATIVES ARE EDUCATED ABOUT COMMUNITY CARE AND IF PATIENTS INDICATE THEY DON'T FEEL THEY CAN PAY, STAFF WILL GET THEM THE FAP AND APPLICATION. NURSING, PHYSICIANS AND ALL PATIENT CARE STAFF ARE EDUCATED ABOUT FAP AND SHARE WITH PATIENTS WHO INDICATED A NEED. RIVERWOOD ALSO HAS DAILY PATIENT CENTERED BEDSIDE ROUNDING WHERE ALL INPATIENTS AND THEIR FAMILIES GET TO MEET WITH THE HOSPITAL'S HEALTHCARE TEAM, WHICH INCLUDES THE FINANCIAL COUNSELOR. EVERY TEAM MEMBER INTRODUCES THEMSELVES AND EXPLAINS WHAT THEY DO, WITH THE FINANCIAL COUNSELOR INFORMING THE PATIENT ABOUT HER AVAILABILITY TO ASSIST THEM WITH ANY OF THEIR INSURANCE OR FINANCIAL NEEDS. EACH INPATIENT ALSO 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, LINE 7A, CHNA - HOSPITAL'S WEBSITE: HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2025/09/2025-PRC-CHNA-REPORT-RIVERWOOD-HEALTHCARE-CENTER.PDF PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE: HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2026/02/2026-RIVERWOOD-IMPLEMENTATION-STRATEGY-.PDF PART V, LINE 16A, FAP WEBSITE: HTTPS://RIVERWOODHEALTHCARE.ORG/FINANCIAL-ASSISTANCE/ PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2026/06/4-POLICY-4-COMMUNITY-CARE-APP-A.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY: HTTPS://RIVERWOODHEALTHCARE.ORG/PLAIN-LANGUAGE-FINANCIAL-ASSISTANCE-PLAN/ PART V, SECTION B, LINE 11 (CONTINUED): IN SUPPORT OF SUBSTANCE ABUSE, RIVERWOOD HAS A MULTI-DISCIPLINARY TEAM TO ASSIST PATIENTS WITH OPIOID ADDICTIONS AND TO REDUCE PRESCRIBING OF SUCH MEDICINES. THE TEAM CONSISTS OF PHYSICIANS, NURSES, PHARMACISTS, BEHAVIORAL HEALTH SPECIALISTS AND SOCIAL WORKERS WHO MEET MONTHLY. THE FREE TOOL, FINDHELP.ORG, IS UTILIZED AT RIVERWOOD TO ASSIST PATIENTS WITH FINDING COMMUNITY HELP THEY MIGHT NEED INCLUDING HUNGER, DIETARY NEEDS, CHRONIC CARE MANAGEMENT, ETC. THIS IS ACCOMPLISHED AS A PART OF AN ANNUAL VISIT AS A QUESTIONNAIRE AND ALLOWS THE PATIENT'S CARE GIVER TO HELP THEM MEET UNMET NEEDS AS RELATED TO THEIR SOCIAL DETERMINANTS OF HEALTH AND "FIND HELP." 3 1 - RIVERWOOD AITKIN CLINIC 200 BUNKER HILL DRIVE AITKIN MN 56431 CLINIC 2 - RIVERWOOD MCGREGOR CLINIC 2 E CENTRAL AVENUE MCGREGOR MN 55760 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 2025 MEDICARE COST REPORT. PART I, LN 7 COL(F): IMPLICIT PRICE CONCESSIONS FROM FINANCIAL STATEMENTS IS 1,337,092. PART I, LINE 6A: THE ORGANIZATION FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH MINNESOTA. THIS INFORMATION IS AVAILABLE ON THE MINNESOTA HOSPITAL ASSOCIATION WEBSITE. PART II, COMMUNITY BUILDING ACTIVITIES: N/A PART III, LINE 2: TO DETERMINE IMPLICIT PRICE CONCESSIONS, RIVERWOOD FILTERS THE ACCOUNTS RECEIVABLE DETAIL MONTHLY BY SELF-PAY. THOSE SELF-PAY BALANCES THEN GET PLACED INTO BUCKETS BASED ON THEIR SERVICE DATE. RIVERWOOD THEN APPLIES AN INCREASINGLY LARGER PERCENTAGE BASED ON THE AGING OF THE SELF-PAY BALANCE; THE OLDER THE BALANCE IS, THE MORE GETS ALLOWED FOR AND BECOMES IMPLICIT PRICE CONCESSIONS. PERCENTAGE OF DISCOUNT FOR EACH BUCKET IS ADJUSTED BASED ON PATIENT TYPE, PAYOR, AND THE RECENT PAYMENT AND ADJUSTMENT HISTORY FOR THOSE CLAIM CATEGORIES. PART III, LINE 3: AT RIVERWOOD HEALTHCARE CENTER, IMPLICIT PRICE CONCESSIONS ARE CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE THE INABILITY TO PAY. PART III, LINE 4: SEE FOOTNOTE 1 ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. PART III, LINE 9B: AITKIN COMMUNITY HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED RATES TO RESIDENTS OF THE COMMUNITY, PRIMARILY TO THE UNINSURED AND TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE UNABLE DUE TO SOCIO-ECONOMIC FACTORS. THE HOSPITAL EMPLOYS A FULL TIME FINANCIAL COUNSELOR WHO WORKS WITH PATIENTS TO EVALUATE ELIGIBILITY AND REDIRECT THEM AS NEEDED TO LOCAL STATE OR COUNTY STAFF FOR ASSISTANCE WITH APPLICATIONS FOR GOVERNMENTAL ASSISTANCE PROGRAMS. UPON RECEIPT OF DENIAL, PATIENT WILL BE PROVIDED A CHARITY CARE APPLICATION. DEPENDING ON THE PATIENT'S INCOME AND THE GUIDELINES, THEY WILL BE PROVIDED A WAIVER OF ALL CHARGES OR A REDUCTION IN THEIR MEDICAL CHARGES. THE HOSPITAL'S BILLING STAFF, PATIENT ACCESS STAFF AND OUTSIDE COLLECTION AGENCIES ARE ALL EDUCATED AND AWARE OF THE CHARITY CARE ASSISTANCE PROGRAM AND IN THE COURSE OF THEIR EVERYDAY WORK WILL OFFER PATIENTS THIS INFORMATION IF THEY EXPRESS A NEED FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSMENT:TO CONTINUE SUPPORTING THE PUBLIC'S MENTAL HEALTH, RIVERWOOD OFFERS FREE AND CONFIDENTIAL GROUP COUNSELING SESSIONS TO INDIVIDUALS NEEDING GRIEF SUPPORT. AN EXPERIENCED BEREAVEMENT COUNSELING LEADER HEADS UP THE GROUP. MENTAL HEALTH PLAYS A KEY ROLE IN THE WELL-BEING OF ALL OUR PATIENTS. TO MAKE PATIENTS MENTALLY HEALTHIER, RIVERWOOD HOLDS VIRTUAL SEMINARS FROM FOUR RIVERWOOD BEHAVIORAL HEALTH PROFESSIONALS INCLUDING QUESTION-AND-ANSWER SESSIONS. PARTICIPANTS SUBMIT A QUESTION WITH THEIR REGISTRATION OR VIA THE CHAT FUNCTION DURING THE PROGRAM. THE PRESENTERS INCLUDED RIVERWOOD'S PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONERS LICENSED INDEPENDENT CLINICAL SOCIAL WORKERS. STAFF TALK ABOUT SELF-CARE AND HOW SPECIFIC ACTIVITIES AND PRACTICES CAN HELP YOU TAKE CARE OF YOUR MENTAL WELL-BEING. MENTAL HEALTH PROBLEMS THAT STOP A PERSON FROM FUNCTIONING WELL OR FEELING GOOD ARE DISCUSSED AS WELL AS HOW PROFESSIONAL HELP CAN MAKE A SIGNIFICANT DIFFERENCE.IN SUPPORT OF OUR YOUNGEST PATIENTS, RIVERWOOD OFFERS FREE BOOKS THROUGH THE RIVERWOOD READS PROGRAM AS WELL AS HAVING PROVIDERS READ THESE BOOKS IN THE SCHOOL CLASSROOMS. WE SPECIFICALLY CHOSE A BOOK TO GO WITH THE CORRELATING WELL CHILD CHECKUP OR SPECIFIC CLASSROOM AGE GROUP. RIVERWOOD PROVIDERS REVIEW THE BOOK WITH THE CHILD AND GUARDIAN DURING THE CHILD'S APPOINTMENT.TO SUPPORT OUR COMMUNITY, RIVERWOOD STAFF VOLUNTEER HOURS TO BENEFIT AREA ORGANIZATIONS SUCH AS SALVATION ARMY, AMERICAN RED CROSS, OPERATION CHRISTMAS, AND AITKIN COUNTY FAIR.TO OFFER FREE SUPPORT, RIVERWOOD OFFERS AN ONLINE SYMPTOM CHECKER WHICH IS A SELF-EVALUATION PLATFORM THAT ENHANCES PATIENT CARE ACCESS AND PATIENT ENGAGEMENT. THIS OFFERS A LIVE CHAT WITH RIVERWOOD STAFF AND GIVES SELECTION LINKS TO PERTINENT CONTENT TO ASSIST PATIENTS IN NAVIGATING TO CARE SERVICES AND GETTING AN APPOINTMENT EFFICIENTLY, ALLOWING CONVENIENT SCHEDULING OF MEDICAL APPOINTMENTS WITHOUT A PHONE CALL.RIVERWOOD HEALTHCARE PROVIDERS OFFER FREE AND INFORMATIVE VIRTUAL SEMINARS TO THE PUBLIC THROUGHOUT THE YEAR. TOPICS SUCH AS MENTAL HEALTH, WELL-BEING, AND SELF-CARE TOPICS. DIETARY AND NUTRITION TIPS ARE GIVEN BY REGISTERED DIETICIANS AND PROVIDED IN NEWSLETTERS ON HEALTHY LIVING. FREE WELLNESS BLOGS ON RIVERWOOD'S WEBSITE COVER A VARIETY OF TOPICS ON HEALTH, WELLNESS, PREVENTION PERTINENT TO THE SEASON OF THE YEAR. PODCASTS OF RIVERWOOD ON CALL ARE AVAILABLE TO ANYONE WHO IS INTERESTED IN LEARNING ABOUT HEALTHY LIVING, BALANCING THE BODY'S SYSTEMS, PREVENTATIVE CARE, AND WELLNESS STRATEGIES. WITH THE IDEA THAT HEALTH SHOULD BE VIEWED IN TERMS OF OVERALL WELL-BEING, CONSIDERING FACTORS LIKE MENTAL, PHYSICAL, AND SOCIAL HEALTH, THESE RECORDINGS ARE FREE TO THE PUBLIC. THEY ARE AVAILABLE ON SPOTIFY, PANDORA, APPLE PODCASTS, IHEART OR ON THE RIVERWOOD WEBSITE. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: AITKIN COMMUNITY HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED RATES TO RESIDENTS OF THE COMMUNITY, PRIMARILY TO THE UNINSURED AND TO PAITENTS 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 DIRECT THEM AS NEEDED TO LOCAL STATE OR COUNTY STAFF FOR ASSISTANCE WITH APPLICATIONS FOR GOVERNMENTAL ASSISTANCE PROGRAMS. UPON RECIEPT OF DENIAL, PATIENT WILL BE PROVIDED A CHARITY CARE APPLICATION. DEPENDING ON THE PATIENT'S INCOME AND THE GUIDELINES, THEY WILL BE PROVIDED A WAIVER OF ALL CHARGES OR A REDUCTION IN THEIR MEDICAL CHARGES. RIVERWOOD'S EMPLOYED FINANICAL COUNSELOR IS A MNSURE NAVIGATOR, TRAINED AND CERTIFIED BY THE STATE OF MN, AND IS AVAILABLE TO ASSIST PATIENT WITH CHECKING FOR THEIR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE, MNSURE, OR TO PURCHASE INSURANCE.THE HOSPITAL'S BILLING STAFF, PATIENT ACCESS STAFF AND OUTSIDE COLLECTION AGENCIES ARE ALL EDUCATED AND AWARE OF THE CHARITY CARE ASSISTANCE PROGRAM AND IN THE COURSE OF THEIR EVERYDAY WORK WILL OFFER PATIENTS THIS INFROMATION IF THEY EXPRESS A NEED FOR FINANCIAL ASSISTANCE. NURSING PROVIDERS AND ALL HEALTHCARE STAFF ARE ALSO AWARE OF THE ASSISTANCE PROGRAM AND CAN HELP DIRECT PATIENTS TO THE FINANCIAL COUNSELOR. PART VI, LINE 4: COMMUNITY INFORMATION:AITKIN COMMUNITY HOSPITAL, INC. DBA RIVERWOOD 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. 15,834), THE EAST SIDE OF CROW WING COUNTY (POP. 63,855) AND MILLE LACS COUNTY (POP. 25,728). THE GEOGRAPHIC AREA OF THESE COUNTIES IS RURAL. SPECIAL POPULATIONS SERVED INCLUDE THOSE WITH A HIGH RATE OF POVERTY AND UNEMPLOYMENT WITHIN AITKIN COUNTY. IN 2021, THE ESTIMATED PERCENTAGES OF THE COUNTY WITH POPULATIONS BELOW POVERTY LEVEL WAS 12.2% WITH CHILDREN BEING AT 18.0%. POPULATION WITH FAIR OR POOR HEALTH WAS AT 15.8%. OTHER SPECIAL POPULATIONS INCLUDE THE ELDERLY. THE LARGEST PERCENTAGE OF RIVERWOOD'S CURRENT PATIENT BASE CONSISTS OF PATIENTS OVER THE AGE OF 65. AITKIN COUNTY HAS THE OLDEST MEDIAN POPULATION IN THE STATE OF MINNESOTA. THE MEDIAN AGE IS 55.5 YEARS OF AGE COMPARED TO THE MINNESOTA AVERAGE OF 38 YEARS OLD. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: 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. RIVERWOOD REGULARLY PARTNERS WITH AITKIN COUNTY HEALTH AND HUMAN SERVICES, CITY AND COUNTY LAW ENFORCEMENT, AREA SCHOOL DISTRICTS AND OTHER HEALTH CARE PROVIDERS TO EDUCATE, PLAN AND COLLABORATE ON HEALTHCARE NEEDS OF THE COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:N/A PART VI, LINE 7, REPORTS FILED WITH STATES MN 0 RIVERWOOD HEALTHCARE CENTER & COMMUNITY HOSPITAL FOUNDATION 200 BUNKER HILL AITKIN MN 56431 411738787 501(C)(3) 19022 73430 FMV DONATED SUPPLIES TO PROVIDE ADMINISTRATIVE SUPPORT 1 0 DOLLARS FOR SCHOLARS HEALTHCARE EDUCATION SCHOLARSHIP 2 3000 RIVERWOOD EMPLOYEE HIGH SCHOOL SENIOR STUDENT SCHOLARSHIP 4 1000 PART I, LINE 2: THE HOSPITAL PAYS FOR CERTAIN ADMINISTRATIVE EXPENSES FOR THE FOUNDATION. X X X X X X 0 0 0 0 0 0 0 0 0 DR DAVID TAYLOR CMO 630403 0 0 0 276 0 13800 0 44969 0 689448 0 0 0 KEN WESTMAN CEO 499688 0 51643 0 1518 0 13800 0 39668 0 606317 0 0 0 DR JEFFREY EHNSTROM DIRECTOR/PHYSICIAN 443776 0 0 0 276 0 13800 0 46396 0 504248 0 0 0 ROBERT SCHMIEG CRNA 447855 0 0 0 792 0 13800 0 41119 0 503566 0 0 0 DR JESSICA HODSON ER PHYSICIAN 435194 0 0 0 120 0 13800 0 46966 0 496080 0 0 0 DR JIM HARRIS ER PHYSICIAN 405281 0 0 0 0 0 13800 0 41818 0 460899 0 0 0 JANELLE TEPPER CRNA 372442 0 20000 0 180 0 12462 0 45926 0 451010 0 0 0 DONALD HUGHES PHYSICIAN 360228 0 10000 0 792 0 13800 0 39930 0 424750 0 0 0 CASEY JOHNSON CFO 252312 0 15956 0 660 0 10462 0 38055 0 317445 0 0 0 CYNTHIA BAKER COO 252092 0 17262 0 2838 0 0 0 41680 0 313872 0 0 0 A CITY OF AITKIN 416004918 2016-05-17 5985025 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 B CITY OF MCGREGOR 410906736 2016-05-17 8000000 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 C CITY OF TAMARACK 411315842 2016-05-17 8000000 REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001 0 0 0 D CITY OF AITKIN 416004918 2017-12-28 9732000 RENOVATE, EXPAND, EQUIP CLINIC SPACE; BUILD 9 CHAIR KIDNEY DIALYSIS CENTER 0 0 0 A 2928596 5985025 89142 5895883 2013 1 0 1 1 B 3914565 8000000 119153 7880847 2013 1 0 1 1 C 3914565 8000000 119153 7880847 2013 1 0 1 1 D 3401944 9732000 194640 9537360 2019 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A CITY OF MCGREGOR 410906736 2022-12-22 9000000 CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL 0 0 0 B CITY OF AITKIN 416004918 2022-12-22 10000000 CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL 0 0 0 C CITY OF TAMARACK 411315842 2022-12-22 10000000 CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL 0 0 0 D CITY OF GARRISON 410984999 2022-12-22 8500000 CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL 0 0 0 A 124863 9000000 248443 8751557 2024 0 0 0 1 B 138737 10000000 277430 9722570 2024 0 0 0 1 C 138737 10000000 276600 9723400 2024 0 0 0 1 D 117926 8500000 235110 8264890 2024 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 1 BREMER CDE 12.500000000000 0 0 0 0 1 B 0 0 1 0 1 1 BREMER CDE 12.500000000000 0 0 0 0 1 C 0 0 1 0 1 1 BREMER CDE 12.500000000000 0 0 0 0 1 D 0 0 1 0 1 1 BREMER CDE 12.500000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE CONTINUED: HEALTHGRADES ANNOUNCED IN MAY 2025 THAT IT RECOGNIZED RIVERWOOD WITH AN OUTSTANDING PATIENT EXPERIENCE AWARD. THIS ACHIEVEMENT REFLECTS RIVERWOOD'S COMMITMENT TO COMPASSIONATE, PATIENT-CENTERED CARE AND PLACES THE ORGANIZATION IN THE TOP 5 PERCENT OF HOSPITALS NATIONWIDE FOR PATIENT EXPERIENCE. RIVERWOOD CEO KEN WESTMAN STATED, "THIS IS A PRESTIGIOUS HONOR THAT REFLECTS THE HIGH LEVEL OF CARE AND COMPASSION OUR STAFF DELIVERS TO PATIENTS EVERY DAY. BEING NAMED AMONG THE TOP 5% OF HOSPITALS NATIONWIDE FOR PATIENT EXPERIENCE IS A DIRECT RESULT OF OUR TEAM'S UNWAVERING DEDICATION TO PUTTING PATIENTS FIRST. FROM THE MOMENT SOMEONE WALKS THROUGH OUR DOORS TO THE FOLLOW-UP AFTER A VISIT OR HOSPITAL STAY, WE ARE FOCUSED ON DELIVERING CARE THAT IS NOT ONLY CLINICALLY EXCELLENT BUT ALSO DEEPLY PERSONAL. WITH A STRONG CULTURE OF TEAMWORK, RESPECT, AND EMPATHY, WE STRIVE TO CREATE AN ENVIRONMENT WHERE EVERY PATIENT FEELS SEEN, HEARD, AND VALUED." HEALTHGRADES EVALUATED MORE THAN 3,000 HOSPITALS THAT SUBMITTED AT LEAST 100 HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) SURVEYS, COVERING ADMISSIONS FROM JANUARY 2023 TO DECEMBER 2023. TO DETERMINE THE RECIPIENTS OF THE OUTSTANDING PATIENT EXPERIENCE AWARD, HEALTHGRADES APPLIES A SCORING METHODOLOGY TO 10 PATIENT EXPERIENCE MEASURES. THESE MEASURES FOCUS ON PATIENTS' PERCEPTIONS OF THEIR HOSPITAL CARE, INCLUDING STAFF COMMUNICATION, MEDICATION EXPLANATIONS, AND CLEANLINESS. THE 2025 POPULATION HEALTH PIONEER AWARD RECOGNIZES HEALTH CARE ORGANIZATIONS AND PROVIDER PARTNERS FOR THEIR EXEMPLARY WORK AND INNOVATIVE APPROACHES IN VALUE-BASED CARE TO IMPROVE THE QUALITY OF CARE FOR THEIR PATIENTS AND COMMUNITIES. RIVERWOOD WAS HONORED TO RECEIVE THE AWARD PRESENTED BY WELLVANA. THE MINNESOTA HOSPITAL ASSOCIATION RECOGNIZED RIVERWOOD AS THE RECIPIENT OF THE 2025 QUALITY AND SAFETY IMPROVEMENT AWARD, RECOGNIZING THE ORGANIZATION'S OUTSTANDING COMMITMENT TO PATIENT SAFETY AND CONTINUOUS QUALITY IMPROVEMENT. THIS PRESTIGIOUS AWARD CELEBRATES HOSPITALS THAT TAKE EXTRAORDINARY AND INNOVATIVE STEPS TO MAKE SAFETY A TOP PRIORITY. RIVERWOOD WAS SELECTED FOR ITS DEEPLY EMBEDDED CULTURE OF SAFETY, DRIVEN BY LEAN THINKING, JUST CULTURE PRINCIPLES, AND A SYSTEM-WIDE COMMITMENT TO ZERO HARM. KEY INITIATIVES INCLUDE LEAN WORKSHOPS, A REAL-TIME QUALITY AND SAFETY DASHBOARD, SENIOR LEADERSHIP ROUNDING, AND MONTHLY HIGH-RELIABILITY SAFETY MESSAGING. RIVERWOOD'S FALLS GUARDIAN PROGRAM, WHICH REDUCED INPATIENT FALLS BY NEARLY 50% IN ONE YEAR, STOOD OUT AS A MODEL OF PROACTIVE, PATIENT-CENTERED INNOVATION. "THIS AWARD REFLECTS THE DEDICATION OF OUR ENTIRE TEAM TO CREATING A SAFE, HIGH-QUALITY ENVIRONMENT FOR EVERY PATIENT, EVERY DAY," SAID WENDY FRANKE, CHIEF QUALITY OFFICER OF RIVERWOOD HEALTHCARE CENTER. "WE'RE HONORED TO BE RECOGNIZED AND REMAIN COMMITTED TO SUSTAINING AND GROWING THESE EFFORTS." RIVERWOOD HEALTHCARE CENTER IN AITKIN HAS BEEN RECOGNIZED AS A COMPREHENSIVE ADVANCED LIFE SUPPORT (CALS) HOSPITAL, JOINING AN ELITE GROUP OF FACILITIES DEDICATED TO EXCELLENCE IN RURAL EMERGENCY CARE. THIS DESIGNATION REFLECTS RIVERWOOD'S COMMITMENT TO HIGH STANDARDS IN STAFF TRAINING, USE OF STATE-OF-THE-ART TECHNOLOGY, AND ADHERENCE TO CALS PRINCIPLES. "RIVERWOOD FIRST RECEIVED THIS DESIGNATION IN 2008 AND HAS LONG RECOGNIZED THE VALUE OF EXCELLENCE IN EMERGENCY MEDICINE EDUCATION," SAID DR. DAVID TAYLOR, EMERGENCY PHYSICIAN AND CHIEF MEDICAL OFFICER AT RIVERWOOD. "WE ARE PROUD TO HAVE MET THE CALS CRITERIA AT THE HIGHEST POSSIBLE LEVEL, WITH 100% OF OUR NURSES AND PROVIDERS TRAINED IN CALS. IN ADDITION, WE HAVE SECURED THE RECOMMENDED EQUIPMENT AND DEMONSTRATED OUR FULL COMMITMENT TO CALS PRINCIPLES." CALS IS AN EDUCATIONAL PROGRAM DESIGNED TO PREPARE MEDICAL PERSONNEL IN RURAL SETTINGS TO ANTICIPATE, RECOGNIZE, AND MANAGE LIFE-THREATENING EMERGENCIES. DEVELOPED IN MINNESOTA IN 1996, CALS TRAINING EMPHASIZES A SYSTEMATIC, TEAM-BASED APPROACH TO EMERGENCY CARE AND IS NOW TAUGHT IN MULTIPLE STATES ACROSS THE COUNTRY. RIVERWOOD HAS PARTICIPATED IN CALS TRAINING SINCE 2001. OVER THE PAST TWO DECADES, 278 TEAM MEMBERS HAVE COMPLETED CALS CERTIFICATION BY ATTENDING COURSES EITHER ON-SITE IN AITKIN OR AT OTHER REGIONAL LOCATIONS. THIS MILESTONE REFLECTS RIVERWOOD'S ONGOING DEDICATION TO PROVIDING HIGH-QUALITY EMERGENCY CARE TO RESIDENTS OF AITKIN AND THE SURROUNDING COMMUNITIES. RIVERWOOD HEALTHCARE CENTER IS DESIGNATED AS AN ACUTE STROKE READY HOSPITAL, MEETING HIGH STANDARDS OF CARE FOR THE INITIAL TREATMENT OF STROKE PATIENTS WHEN QUICK ACTION AND PROPER MEDICATION CAN SAVE LIVES AND LIMIT THE LONG-TERM DISABLING EFFECTS OF A STROKE. THESE AWARDS AND RECOGNITIONS ARE POSSIBLE BECAUSE OF THE PATIENTS WHO ENTRUST RIVERWOOD WITH THEIR CARE AND THE COMPASSIONATE SERVICE PROVIDED BY RIVERWOOD'S EMPLOYEES. RIVERWOOD, ALONG WITH 19 OTHER INDEPENDENT RURAL MINNESOTA HOSPITALS, CONTINUES TO COLLABORATE WITH THE HEADWATERS HIGH-VALUE NETWORK, WORKING TOGETHER ON CLINICAL AND BUSINESS INITIATIVES TO STRENGTHEN HEALTHCARE IN RURAL COMMUNITIES ACROSS THE STATE. THE CENTERPIECE OF THE HEADWATERS COLLABORATION IS A CLINICALLY INTEGRATED NETWORK (CIN) FEATURING 20 HOSPITALS AND MORE THAN 50 CLINICS THAT WILL PROVIDE COORDINATED CARE TO MORE THAN 750,000 MINNESOTANS. THE NETWORK ALSO WILL SET UP OPERATIONAL COLLABORATIONS DESIGNED TO CONTROL COSTS AND SPREAD BEST PRACTICES AMONG ITS MEMBERS. NETWORKS LIKE THE HEADWATERS HVN AND THE ROUGH RIDER HIGH-VALUE NETWORK IN NORTH DAKOTA ARE INNOVATIVE MODELS FOR RURAL HOSPITALS TO BAND TOGETHER TO MEET THE MOUNTING CHALLENGES OF DELIVERING HEALTHCARE IN RURAL COMMUNITIES. THE CAPABILITIES NEEDED TO THRIVE IN HEALTHCARE TODAY, SUCH AS CONTROLLING THE RISING COSTS OF PROVIDING CARE AND EXPANDING CARE COORDINATION, ARE ENHANCED WITH ECONOMIES OF SIZE AND SCALE. AS THE COLLABORATION DEEPENS AMONG MEMBERS, THE HEADWATERS HVN WILL BE A STRONG PARTNER WITH PAYERS ON VALUE-BASED INSURANCE PRODUCTS THAT IMPROVE QUALITY, REDUCE COST, AND ENHANCE PATIENT AND PROVIDER EXPERIENCE. "THE MEMBERS OF THE HEADWATERS NETWORK BELIEVE THAT HELPING RURAL HOSPITALS REMAIN INDEPENDENT IS THE BEST WAY TO SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITIES," SAID KEN WESTMAN, CHAIR OF THE HEADWATERS BOARD AND CEO OF RIVERWOOD HEALTHCARE CENTER IN AITKIN, MINN. "WE ALSO BELIEVE THAT OUR INDEPENDENCE IS STRENGTHENED BY OUR INTERDEPENDENCE. THE MORE WE CAN WORK TOGETHER, THE BETTER WE CAN CARE FOR OUR COMMUNITIES." THE HEADWATERS NETWORK IS IN DISCUSSIONS WITH OTHER RURAL HOSPITALS IN MINNESOTA INTERESTED IN JOINING AS MEMBERS AND EXPECTS TO GROW. HEADWATERS LEADERSHIP ANNOUNCED THAT THE HEADWATERS HVN BOARD OF DIRECTORS INCLUDES SEVEN LEADERS FROM MEMBER RURAL HOSPITALS ACROSS MINNESOTA. THE ACTIVE DAILY MANAGEMENT OF THE NETWORK WILL BE LED BY PRINCIPALS FROM CIBOLO HEALTH. CIBOLO HEALTH HELPS INDEPENDENT RURAL HOSPITALS CREATE CLINICALLY INTEGRATED NETWORKS WITH THEIR PEERS TO OVERCOME THE OBSTACLES RURAL HEALTHCARE PROVIDERS FACE. THE HEADWATERS CIN WILL DRIVE CARE COORDINATION EFFORTS AND REDUCE ADMINISTRATIVE BURDENS FOR PROVIDERS. THE NETWORK INCLUDES A CLINICAL INTEGRATION COMMITTEE (CIC) TO OVERSEE ALL CLINICAL AND QUALITY INITIATIVES. THE COMMITTEE INCLUDES ONE MEDICAL PRACTITIONER FROM EACH MEMBER HOSPITAL. THE HEADWATERS HVN ALSO WILL PROVIDE MEMBER HOSPITALS WITH A MENU OF SHARED SERVICES THAT PROMOTE MORE EFFICIENT OPERATIONS. THE NETWORK IS EXPLORING SHARED SOLUTIONS IN POPULATION HEALTH PLATFORMS, DATA ANALYTICS, CARE MANAGEMENT SOLUTIONS, AND OTHER AREAS. "EVERYONE INVOLVED WITH HEADWATERS HAS A GREAT SENSE OF COLLABORATION, A HIGH 'COLLABORATIVE IQ,' THAT WILL HELP US SUSTAIN INDEPENDENT HOSPITALS FOR THE LONG TERM," WESTMAN SAID. "WE UNDERSTAND THAT WORKING TOGETHER WORKS FOR OUR COMMUNITIES." IN SUMMARY, RIVERWOOD HEALTHCARE CENTER'S PROGRAM SERVICE ACCOMPLISHMENTS DEMONSTRATE ITS CONTINUED COMMITMENT TO FULFILLING ITS NONPROFIT MISSION BY IMPROVING COMMUNITY HEALTH, EXPANDING ACCESS TO NEEDED RESOURCES, STRENGTHENING RURAL HEALTH CARE DELIVERY, AND PROVIDING HIGH-QUALITY, PATIENT-CENTERED SERVICES. THROUGH COMMUNITY PARTNERSHIPS, FOOD ACCESS INITIATIVES, PATIENT EXPERIENCE EFFORTS, QUALITY AND SAFETY IMPROVEMENTS, EMERGENCY CARE READINESS, STROKE READINESS, AND REGIONAL COLLABORATION, RIVERWOOD CONTINUES TO ADDRESS IDENTIFIED COMMUNITY NEEDS AND SUPPORT THE HEALTH AND WELL-BEING OF THE RESIDENTS IT SERVES. FORM 990, PART VI, SECTION A, LINE 6 RIVERWOOD HEALTHCARE CENTER HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A RIVERWOOD HEALTHCARE CENTER HAS MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD HAS AUTHORIZED THE FINANCE COMMITTEE TO REVIEW AND APPROVE THE 990 AFTER PREPARATION. AFTER APPROVAL BY THE FINANCE COMMITTEE, THE 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. CONFLICTS ARE DISCUSSED, REVIEWED, AND FORMS ARE SIGNED ANNUALLY BY EACH BOARD MEMBER. THIS IS DONE AT THE HOSPITAL'S ANNUAL REORGANIZATIONAL MEETING. SECTION 1. PURPOSE THE PURPOSE OF THIS POLICY IS TO PROVIDE A MEANS BY WHICH TO ADDRESS ANY CONFLICT OF INTEREST INVOLVING THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, AND EMPLOYEES THAT AFFECT OR HAVE THE POTENTIAL TO AFFECT THE SAFETY OR QUALITY OF CARE, TREATMENT, AND SERVICES. SECTION 2. PERSONS CONCERNED THIS STATEMENT IS DIRECTED NOT ONLY TO BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, BUT TO ALL EMPLOYEES OR NON-EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF RHCC. FOR EXAMPLE, THIS WOULD INCLUDE ALL WHO MAKE PURCHASING DECISIONS, ALL PERSONS WHO MIGHT BE DESCRIBED AS "MANAGEMENT PERSONNEL, AND ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING RHCC. SECTION 3. AREAS IN WHICH CONFLICT MAY ARISE CONFLICTS OF INTEREST MAY ARISE IN THE RELATIONS OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WITH ANY OF THE FOLLOWING THIRD PARTIES: 1. PERSONS AND FIRMS SUPPLYING GOODS AND SERVICES TO RHCC. 2. PERSONS AND FIRMS FROM WHOM RHCC LEASES PROPERTY AND EQUIPMENT. 3. PERSONS AND FIRMS WITH WHOM RHCC IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES, OR OTHER PROPERTY. 4. COMPETING OR AFFINITY ORGANIZATIONS. 5. DONORS AND OTHERS SUPPORTING RHCC. 6. AGENCIES, ORGANIZATIONS AND ASSOCIATIONS WHICH AFFECT THE OPERATIONS OF RHCC. 7. FAMILY MEMBERS, FRIENDS, AND OTHER EMPLOYEES. SECTION 4. NATURE OF CONFLICTING INTEREST A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS MENTIONED IN SECTION 3. SUCH AN INTEREST MIGHT ARISE THROUGH: SECTION 5. INTERPRETATION OF THIS STATEMENT OF POLICY THE AREAS OF CONFLICTING INTEREST LISTED IN SECTION 3, AND THE RELATIONS IN THOSE AREAS WHICH MAY GIVE RISE TO CONFLICT, AS LISTED IN SECTION 4, ARE NOT EXHAUSTIVE. CONFLICTS MIGHT ARISE IN OTHER AREAS OR THROUGH OTHER RELATIONS. IT IS ASSUMED THAT THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WILL RECOGNIZE SUCH AREAS AND RELATION BY ANALOGY. THE FACT THAT ONE OF THE INTERESTS DESCRIBED IN SECTION 4 EXISTS DOES NOT NECESSARILY MEAN THAT A CONFLICT EXISTS, OR THAT THE CONFLICT, IF IT EXISTS, IS MATERIAL ENOUGH TO BE OF PRACTICAL IMPORTANCE, OR IF MATERIAL, THAT UPON FULL DISCLOSURE OF ALL RELEVANT FACTS AND CIRCUMSTANCES IT IS NECESSARILY ADVERSE TO THE INTERESTS OF RHCC. HOWEVER, IT IS THE POLICY OF THE GOVERNING BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS DESCRIBED IN SECTION 4 SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. SECTION 6. DISCLOSURE POLICY AND PROCEDURE PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST AND ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE GOVERNING BOARD OF DIRECTORS OR TO A COMMITTEE WITH BOARD-DELEGATED POWERS; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL BE EXCLUDED FROM THE DISCUSSION AND VOTE ON APPROVAL OF SUCH TRANSACTION; 3. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 4. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER RHCC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST; 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN RHCC'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO RHCC, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. DISCLOSURE DISCLOSURE IN RHCC SHOULD BE MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE GOVERNING BOARD OF DIRECTORS. DISCLOSURE INVOLVING DIRECTORS SHOULD BE MADE TO THE GOVERNING BOARD CHAIR (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE GOVERNING BOARD VICE-CHAIR) WHO SHALL BRING THESE MATTERS TO THE GOVERNING BOARD. DECISION THE GOVERNING BOARD OF DIRECTORS OR A COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO RHCC. IN THE CASE OF A CONFLICT INVOLVING A MEMBER OF THE GOVERNING BOARD OF DIRECTORS, THE GOVERNING BOARD OR COMMITTEE REVIEWING THE MATTER SHALL CONSIDER THE DISABLING GUIDELINES ATTACHED HERETO. THE DECISION OF THE GOVERNING BOARD OR COMMITTEE ON THESE MATTERS WILL REST IN ITS SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF RHCC AND THE ADVANCEMENT OF RHCC'S PURPOSE. SECTION 7. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY 1. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. 2. IF, AFTER HEARING THE RESPONSE OF THE PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE NO ACTION, REPRIMAND, REQUEST FOR RESIGNATION OR REMOVAL FROM THE BOARD OF DIRECTORS AS THE FACTS AND CIRCUMSTANCES MAY WARRANT. SECTION 9. COMPENSATION 1. A VOTING MEMBER OF THE BOARD OF DIRECTORS WHO RECEIVES COMPENSATION FOR PROVISION OF SERVICES AS AN EMPLOYEE OR CONTRACTOR, DIRECTLY OR INDIRECTLY, FROM RHCC IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 2. A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 3. NO MEMBER OF THE BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. 4. PHYSICIANS WHO RECEIVE COMPENSATION FROM RHCC, WHETHER DIRECTLY OR INDIRECTLY OR AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS. NO PHYSICIAN, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING PHYSICIAN COMPENSATION. SECTION 10. ANNUAL STATEMENTS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING OR FOUNDATION BOARD DELEGATED POWERS, AND ALL LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON-- 1. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2. HAS READ AND UNDERSTANDS THE POLICY; 3. HAS AGREED TO COMPLY WITH THE POLICY; AND 4. UNDERSTANDS THAT RHCC IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 RIVERWOOD HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT MEETS AT LEAST QUARTERLY TO REVIEW, DISCUSS, AND RECOMMEND ANY COMPENSATION CHANGES FOR THE CEO. THIS IS DONE WITH EXTERNAL MARKET DATA CONDUCTED BY AN INDEPENDENT FIRM (MOST RECENTLY ARTHUR J. GALLAGHER COMPANIES). THE COMPENSATION COMMITTEE RELIES HEAVILY ON THAT EXTERNAL INDEPENDENT DATA AND IN ACCORDANCE WITH RIVERWOOD'S COMPENSATION PHILOSOPHY, IS UTILIZED TO MAKE RECOMMENDATION TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. THE DATA UTILIZED FOR CEO COMPENSATION WAS LAST UPDATED/COMPLETED MAY 2023, AND WILL BE CONDUCTED EVERY 2 YEARS. DOCUMENTATION AND RECORD KEEPING IS MAINTAINED FOR BOTH COMPENSATION COMMITTEE AND BOARD OF DIRECTORS MEETINGS IN WHICH CEO COMPENSATION DISCUSSIONS AND/OR DECISIONS OCCUR. FOR KEY EMPLOYEES AND OTHER OFFICERS, THE CEO DETERMINES THEIR COMPENSATION LEVEL, BUT OFTEN REPORTS ON IT TO THE EXECUTIVE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 RIVERWOOD ANNUALLY PRODUCES A FISCAL YEAR-END FINANCIALS REPORT SHOWING THE ORGANIZATION'S FINANCIAL STATUS VIA A STATEMENT OF OPERATIONS, STATISTICAL HIGHLIGHTS AND COMMUNITY BENEFITS STATEMENT. THIS REPORT IS MADE AVAILABLE TO THE PUBLIC FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IT IS DISTRIBUTED TO MEMBERS OF THE ORGANIZATION AT AN ANNUAL MEETING AND IS POSTED TO OUR WEBSITE IN THE ABOUT US SECTION. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,469,295. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,469,295. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 13,299,624. MANAGEMENT AND GENERAL EXPENSES 1,996,357. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,295,981. FORM 990, PART XI, LINE 9: DECREASE IN INTEREST IN NET ASSETS OF RIVERWOOD FOUNDATION -5,237,309. UNREALIZED GAIN ON INTEREST RATE SWAPS 726,223. OTHER CHANGES TO NET ASSETS 134,019. FORM 990, PART IV (LINES 11F AND 12B) AND PART XII (LINE 2B): AS OF THE DATE OF FILING THIS FORM 990, THE ORGANIZATION IS IN THE PROCESS OF FINALIZING ITS AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. THE AMOUNTS REFLECTED ON FORM 990 ALIGN WITH THE DRAFT AUDIT REPORT. 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