2023-08-16T13:53:31-05:00 2022-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-10-01 410724029 RIVERVIEW HEALTHCARE ASSOCIATION RIVE 2182819200 323 SOUTH MINNESOTA STREET CROOKSTON MN 56716 CARRIE MICHALSKI PRESIDENT & CEO 2182819200 2023-08-15 1 CARRIE MICHALSKI 999009999 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-08-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z RIVERVIEW HEALTH AND SUBSIDIARY CARRIE MICHALSKI 323 SOUTH MINNESOTA STREET CROOKSTON MN 56716 66261673 0 X WWW.RIVERVIEWHEALTH.ORG X 1898 MN RIVERVIEW HEALTH PROVIDES WORLD-CLASS HEALTHCARE THROUGH A CULTURE OF EXCELLENCE THAT PROVIDES ACCESS TO OUR COMMUNITY FOR ALL HEALTHCARE NEEDS SERVING AS AN ADVOCATE FOR OUR COMMUNITY, PATIENTS, MEDICAL STAFF AND EMPLOYEES. 9 7 436 170 0 0 9631914 1261889 60831814 63572392 114367 193820 978340 1233572 71556435 66261673 0 0 0 0 35043532 35400976 0 0 0 31677403 36832823 66720935 72233799 4835500 -5972126 104798732 90134185 72632520 64253187 32166212 25880998 X WE DELIVER A HEALTHCARE EXPERIENCE THAT CONSISTENTLY EXCEEDS PATIENTS' EXPECTATIONS THROUGH EXCEPTIONAL PEOPLE - OUR PEOPLE ARE OUR FOUNDATION. WE EMPLOY TRUSTED, DEDICATED PROFESSIONALS WHO SERVE WITH COMPASSION, EMPATHY AND RESPECT. EXCEPTIONAL CARE - OUR PATIENTS ARE OUR FOCUS. WE BUILD RELATIONSHIPS TO DELIVER PERSONALIZED CARE. EXCEPTIONAL OUTCOMES - OUR PASSION IS TO ENHANCE LIVES. WE ENGAGE IN THE BEST PRACTICES TO HEAL PEOPLE AND PROMOTE HEALTHY COMMUNITIES. 0 0 54885932 0 57876168 RIVERVIEW HEALTHCARE DIRECTLY PROVIDES OR SUPPORTS THE PROVISION OF A CONTINUUM OF QUALITY, ACCESSIBLE AND COST-EFFECTIVE SERVICES FOCUSED ON THE NEEDS OF INDIVIDUALS. RIVERVIEW STRIVES TO MEET AREA MEDICAL NEEDS AND IMPROVE THE PHYSICAL AND MENTAL WELLBEING FOR PEOPLE OF THE AREA. THE HOSPITAL IS A MODERN 25-BED ACUTE CARE CRITICAL ACCESS HOSPITAL. FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2022, THE HOSPITAL HAD 758 ADMISSIONS, 1,698 PATIENT DAYS, 48,845 OUTPATIENT VISITS, 1,622 SURGERIES, AND 6,098 ER PATIENT VISITS. THE CLINICS PROVIDE A WIDE RANGE OF SERVICES INCLUDING FAMILY PRACTICE DOCTORS AND SPECIALTY DOCTORS. FOR THE YEAR ENDED SEPTEMBER 30, 2022, CLINIC PAITIENT VISITS WERE 32,202. 3930329 0 4144457 RIVERVIEW CARE CENTER PROVIDES STIMULATING DAILY ACTIVITIES FOR ITS RESIDENT IN AN ENJOYABLE ENVIRONMENT AND A CARING ATMOSPHERE WHERE ALL RESIDENTS ARE TREATED WITH THE UTMOST DIGNITY. THE MEMORY CARE UNIT PROMOTES A CALM AND THERAPEUTIC ATMOSPHERE. RIVERVIEW CARE CENTER IS A 24-BED FACILITY, FOR THE YEAR ENDING SEPTEMBER 30, 2022, THERE WERE 6 NURSING HOME ADMISSIONS AND 7,359 RESIDENT DAYSRIVERVIEW HOME CARE IS A FULL SERVICE HOME CARE AGENCY PROVIDING 24-HOUR ACCESS TO ON CALL NURSES, ROUTINE SERVICE ON WEEKENDS AND HOLIDAYS, AND A FULL RANGE OF THERAPY SERVICES. FOR THE YEAR ENDING SEPTEMBER 30, 2022, THERE WERE 1,330 HOME CARE PAITENTS AND 13,676 PATIENT VISITS. (CONTINUED IN SCHEDULE O)RIVERVIEW ASSISTED LIVING PROVIDES SERVICE TO RESIDENTS IN CROOKSTON. ASSISTANCE FOR THOSE UNABLE TO LIVE ALONE WITHOUT AID INCLUDES HOUSEKEEPING, HELP DRESSING, BATHING, PREPARING MEALS, MEDICATION SET-UP AND MANY OTHER SERVICES. FOR THE YEAR ENDING SEPTEMBER 30, 2022, THERE WERE 196 ASSISTED LIVING PATIENTS AND 5,482 PATIENT VISITS. 1471593 0 1551767 RIVERVIEW RECOVERY CENTER PROVIDES A DAY TREATMENT AND OUTPATIENT TREATMENT PROGRAM EFFECTIVE FOR THE ADULT WHO IS ABUSING OR DEPENDENT ON ONE OR MORE MOOD-ALTERING CHECMICALS. THE RECOVERY CENTER OPERATES CLINICS IN CROOKSTON, EAST GRAND FORKS, THIEF RIVER FALLS, AND ROSEAU, MINNESOTA. FOR THE YEAR ENDING SEPTEMBER 30, 2022, RECOVERY CENTER HAD 1,240 OUTPATIENT VISITS. 60287854 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 131 0 436 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X BETTY ARVIDSON 2182819756 323 SOUTH MINNESOTA ST CROOKSTON MN 56716 DR ERIK KANTEN TRUSTEE/PHYSICIAN 41.00 0.00 X 655230 0 44925 DR BRETT VIBETO TRUSTEE/PHYSICIAN 41.00 0.00 X 460281 0 29665 GRANT GUNDERSON CHAIR 4.00 0.00 X X 0 0 0 ANDY OMAN CHAIR (THRU JAN OF 22) 4.00 0.00 X X 0 0 0 TIM BRINKMAN VICE CHAIR 2.00 0.00 X X 0 0 0 STEPHANIE HARBOTT TREASURER 2.00 0.00 X X 0 0 0 KARI KOENIG SECRETARY 1.00 0.00 X X 0 0 0 MICHELLE COTA TRUSTEE (THRU JAN OF 22) 1.00 0.00 X 0 0 0 LORI KELLER TRUSTEE 1.00 0.00 X 0 0 0 GARRET BOROWICZ TRUSTEE 1.00 0.00 X 0 0 0 REED ENGELSTAD TRUSTEE 1.00 0.00 X 0 0 0 CARRIE MICHALSKI PRESIDENT & CEO 40.00 1.00 X 303170 0 45174 BETTY ARVIDSON CFO / VP OF FINANCE 40.00 1.00 X 168860 0 31200 CHRIS BRUGGEMAN COO / VP OF OPERATIONS 40.00 0.00 X 153381 0 40957 LANCE NORMAN VP OF ANCILLARY SERVICES 40.00 0.00 X 161881 0 23578 APRIL GRUNHOVD CNO / VP OF PATIENT SERVIC 40.00 0.00 X 177783 0 11916 JEAN TATE VP OF HUMAN RESOURCES 40.00 0.00 X 135599 0 22082 DR HAMID ABBASI PHYSICIAN 40.00 0.00 X 891823 0 0 DR OLATUBOSUN FASHORO PHYSICIAN / CHIEF OF STAFF 40.00 0.00 X 862408 0 45511 DR RAM PANERU PHYSICIAN 40.00 0.00 X 784454 0 45505 DR SUNNY KIM PHYSICIAN 40.00 0.00 X 898819 0 0 DR COLIN FENNELL PHYSICIAN 40.00 0.00 X 887466 0 43604 6541155 0 384117 41 0 1 0 SANFORD FARGO CLINIC NORTH PO BOX 2168 FARGO ND 58107 PHYSICIAN & CLINICAL SERVICES 957328 FIRST AMERICAN COMMERCIAL GROUP 1801 W OLYMPIC BLVD PASADENA CA 91199 COMPUTER & MEDICAL EQUIPMENT LEASING 624512 JD GLOBAL MEDICAL INC 107 LIBERTY VIEW INC JERSEY CITY NJ 07302 PHYSICIAN SERVICES 546613 CHG MEDICAL STAFFING INC PO BOX 972633 DALLAS TX 75397 MEDICAL STAFFING SERVICE 384561 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 MEDICAL STAFFING SERVICE 321087 15 168743 1093146 1261889 RIVERVIEW HOSPITAL 621990 34975756 34975756 PHYSICIAN CLINICS 621110 22900412 22900412 RIVERVIEW CARE CENTER 621400 2694403 2694403 RIVERVIEW RECOVERY 621990 1551767 1551767 HOME HEALTH/ASSISTED LIVING 621610 1450054 1450054 63572392 193320 193320 500 0 500 500 500 RETAIL SALES 452000 923208 923208 CAFETERIA 621990 161532 161532 OTHER OPERATING REVENUE 621990 89019 89019 59813 59813 1233572 66261673 63572392 0 1427392 X 2683698 396420 2287278 25936308 23775234 2161074 1197616 1097828 99788 3863812 3541870 321942 1719542 1576266 143276 5755 5755 98168 20359 77809 111650 111650 3780 3780 8828 8828 9723774 8060012 1663762 301944 301944 364983 176297 188686 913732 95423 818309 1251962 492611 759351 98239 91182 7057 2570192 2570192 4595505 4595505 412873 412873 MEDICAL SUPPLIES 8638453 8619996 18457 DRUGS 1827735 1827735 BAD DEBT EXPENSE 1353743 1353743 MAINTENANCE & REPAIRS 1310905 907328 403577 3240602 1089853 2150749 72233799 60287854 11945945 0 2009 8157 33708349 20483773 9940813 10637835 397840 359642 1279162 1131898 274682 273995 100501502 46165389 57792827 54336113 1377260 2682455 25790 220317 104798732 90134185 9408576 7279536 4522205 846912 56355541 54884544 4747 4789 1466005 888290 245892 126816 629554 222300 72632520 64253187 X 32166212 25880998 32166212 25880998 104798732 90134185 -5972126 -313088 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3780 3780 0 PART II-B, LINE 1: RIVERVIEW HEALTHCARE ASSOCIATION PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY THAT HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MINNESOTA HOSPITAL ASSOCIATION THAT WERE USED FOR LOBBYING. 0 1 X 1216280 13055 -124195 51 1105089 1187673 1805 91830 65028 1216280 734564 431375 45555 23821 1187673 1264171 378394 32094 940095 734564 1011633 229213 25658 2333 1264171 1.00000 0.00000 0.00000 0 1 1 1103890 1103890 76472982 29373899 47099083 312690 207318 105372 22611940 16584172 6027768 54336113 ESTIMATED WORKERS' COMPENSATION CLAIMS 222300 222300 X PART IV, LINE 2B: THE HOSPITAL IS A CUSTODIAN OF FUNDS FOR RESIDENTS. THE HOSPITAL HOLDS THESE FUNDS FOR PURCHASES MADE BY THE RESIDENTS. PART V, LINE 4: RIVERVIEW HEALTHCARE'S ENDOWMENT INCLUDES FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. THESE FUNDS ARE MAINTAINED IN THE RIVERVIEW HEALTHCARE FOUNDATION. THE FUNDS ARE USED TO PROVIDE TO THE RESIDENTS OF IT SERVICE AREA, QUALITY HEALTHCARE AND RELATED HEALTH SERVICES, EDUCATION, RESEARCH, PROMOTION OF HEALTH AND OTHER ACTIVITIES IN THE COMMUNITY. THE CONTRIBUTIONS RAISED BY THE FOUNDATION ARE GRANTED TO RIVERVIEW HEALTHCARE ASSOCIATION TO PURCHASE MEDICAL EQUIPMENT AND SUPPLIES FOR PROMOTION OF HEALTHCARE IN THE COMMUNITY. PART X, LINE 2: THE ASSOCIATION FOLLOWS THE PROVISION OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THESE PROVISIONS HAS NO IMPACT ON THE ASSOCIATION'S FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 89788 89788 0.00130 11035322 7576950 3458372 0.04880 11125110 7576950 3548160 0.05010 49449 49449 0.00070 82005 0 82005 0.00120 15082455 13418252 1664203 0.02350 12905 12905 0.00020 15226814 13418252 1808562 0.02560 26351924 20995202 5356722 0.07570 1 1353743 164400 15362589 11666492 3696097 X 1 1 1 1 RIVERVIEW HOSPITAL 323 SOUTH MINNESOTA ST CROOKSTON MN 56716 WWW.RIVERVIEWHEALTH.ORG 375398 X X X X RIVERVIEW HOSPITAL 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, SECTION B, LINE 7D X X 1 22 0 0 0 1 X 150.000000000000 150.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, SECTION B, LINE 16J X SEE PART V, SECTION B, LINE 16J X SEE PART V, SECTION B, LINE 16J X X X X X X X 1 X 0 X X X 1 X 0 0 RIVERVIEW HOSPITAL PART V, SECTION B, LINE 5: RIVERVIEW CONTRACTED WITH CLIFTONLARSONALLEN, LLP TO CONDUCT COMMUNITY INTERVIEWS AND TO ASSIST IN PREPARING THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY.THE INFORMATION WAS GATHERED THROUGH ONE-ON-ONE AND SMALL GROUP INTERVIEWS WITH KEY COMMMUNITY STAKEHOLDERS. THE INFORMATION WAS GATHERED FROM PEOPLE IN PUBLIC HEALTH, GOVERNMENT HEALTH AND OTHER GOVERNMENT AGENCIES, LEADERS OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS.THE FOLLOWING AGENCIES, ORGANIZATIONS, AND BUSINESSES PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASESSMENT PROCESS BY CONTRIBUTING THEIR PERSPECTIVES, OPINIONS, AND OBERVATIONS. WE THANK THEM FOR THEIR PAST AND CONTINUED ASSISTANCE. - POLK COUNTY PUBLIC HEALTH DEPARTMENT- POLK COUNTY SHERIFF'S DEPARTMENT- RIVERVIEW HEALTH- TRI-VALLEY OPPORTUNITY COUNCIL- NORTHWEST MENTAL HEALTH - CROOKSTON PUBLIC SCHOOL DISTRICT- INTER-COUNTY NURSING SERVICE RIVERVIEW HOSPITAL PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT: HTTPS://WWW.RIVERVIEWHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ RIVERVIEW HOSPITAL PART V, SECTION B, LINE 11: IN THE 2013 CHNA REPORT, RIVERVIEW HEALTH IDENTIFIED OBESITY, JOINT OR BACK PAIN, AND HIGH BLOOD PRESSURE AS THE PRIMARY COMMUNITY HEALTH NEEDS. BASED ON THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, RIVERVIEW HEALTH HAS TAKEN THE FOLLOWING STEPS SINCE 2013 TO IMPROVE THE HEALTH OF OUR COMMUNITY:1. RIVERVIEW HEALTH HAS ROLE MODELED AN EMPLOYEE WELLNESS PROGRAM THAT ENCOURAGES HEALTHY EATING CHOICES AND PHYSICAL ACTIVITY AS A MEANS OF MANAGING WEIGHT AND OVERALL HEALTH.2. RIVERVIEW HEALTH HIRED A REGISTERED DIETICIAN THAT SPECIALIZES IN EDUCATION AND PLANNING FOR HEALTHY DIET AND WEIGHT MANAGEMENT, BOTH IN INPATIENT AND OUTPATIENT SETTINGS.3. RIVERVIEW HEALTH IMPLEMENTED A BMI (BODY MASS INDEX) TRACKING SYSTEM AND TARGETED PATIENTS WITH HIGH RISK FACTORS FOR SUPPORT AND EDUCATION.IN JUNE 2016 RIVERVIEW HEALTH PUBLISHED ITS SECOND CHNA REPORT. BASED ON THAT COMMUNITY HEALTH NEEDS ASSESSMENT, RIVERVIEW HEALTH IDENTIFIED OBESITY AND DIABETES AS THE PRIMARY SIGNIFICANT COMMUNITY HEALTH NEED AND SUBSTANCE ABUSE AND MENTAL HEALTH AS THE SECONDARY SIGNIFICANT COMMUNITY HEALTH NEEDS.OBESITY AND DIABETES:RIVERVIEW HEALTH OFFERS INITIATIVES TO ENHANCE THE EDUCATION AND TREATMENT OF OBESITY AND DIABETES IN THE COMMUNITY. IN ADDITION TO HIRING A REGISTERED DIETICIAN THAT SPECIALIZES IN EDUCATION AND PLANNING FOR HEALTHY DIET AND WEIGHT MANAGEMENT, RIVERVIEW HAS HIRED A HEALTH COACH TO OFFER A TEAM BASED APPROACH TO CHRONIC DISEASE MANAGEMENT AND OBESITY. THIS POSITION WORKS COLLABORATIVELY WITH CLINICIANS, PATIENTS AND OTHER SERVICE PROVIDERS TO BETTER MANAGE CHRONIC CONDITIONS IN THE COMMUNITY INCLUDING DIABETES AND OBESITY.RIVERVIEW HEALTH HAS ALSO INCREASED EDUCATIONAL OPPORTUNITIES FOR THOSE SEEKING EDUCATION IN DIABETES AND NUTRITION BY OFFERING A TYPE 2 DIABETES SUPPORT GROUP.RIVERVIEW HEALTH ALSO OFFERS TYPE 2 DIABETES PREVENTION CLASSES IN AN EFFORT TO PREVENT OR REDUCE THE ONSET OF TYPE 2 DIABETES.SUBSTANCE ABUSE AND MENTAL HEALTH:RIVERVIEW HEALTH ALREADY OFFERS OUTPATIENT ADDICTION SERVICE THROUGH ITS RIVERVIEW RECOVERY CENTER.RIVERVIEW RECOVERY CENTER OFFERS AN EXTENSIVE LIST OF OUTPATIENT PROGRAMS THAT ALLOW PATIENTS THE ABILITY TO RECEIVE HIGH-CALIBER CLINICAL CARE WHILE MAINTAINING COMMITMENTS TO WORK, FAMILY AND HOME.OUTPATIENT SERVICES ARE OFFERED AT RIVERVIEW RECOVERY'S LOCATIONS: CROOKSTON, EAST GRAND FORKS, ROSEAU AND THIEF RIVER FALLS.TREATMENTS INCLUDE: - RULE 25 CHEMICAL DEPENDENCY ASSESSMENT: A COMPREHENSIVE CHEMICAL HEALTH ASSESSMENT. - INDIVIDUAL COUNSELING SESSIONS: PROVIDED FOR INDIVIDUALS THAT HAVE COMPLETED TREATMENT AND ARE STRUGGLING WITH THOUGHTS OF USING. - INTENSIVE OUTPATIENT TREATMENT: THIS INCLUDES THREE GROUP COUNSELING MEETINGS PER WEEK, ONE WEEKLY INDIVIDUAL COUNSELING SESSION AND REGULAR URINE DRUG AND ALCOHOL SCREENING FOR INDIVIDUALS STRUGGLING WITH ADDICTION THAT DO NOT MEET CRITERIA FOR RESIDENTIAL TREATMENT. - RELAPSE PREVENTION: RELAPSE PREVENTION INCLUDES ONE INDIVIDUAL COUNSELING SESSION PER WEEK AS WELL AS REGULAR URINE DRUG AND ALCOHOL SCREENING TESTS FOR INDIVIDUALS THAT HAVE COMPLETED TREATMENT, INPATIENT OR INTENSIVE OUTPATIENT, IN THE LAST THREE YEARS AND ARE STRUGGLING WITH ADDICTION. RELAPSE PREVENTION IS INTENDED FOR INDIVIDUALS THAT ARE NOT USING DAILY, BUT WANT TO STOP THE CYCLE. - DRIVING WITH CARE 1: FOR THE FIRST TIME DWI OFFENDER WITH A BLOOD ALCOHOL LEVEL OF LESS THAN .15 AT THE TIME OF ARREST. DRIVING WITH CARE 1 IS A GROUP EDUCATION AND TRAINING PROGRAM THAT HAS PROVEN TO REDUCE RECURRENCE OF DWI. NEW CLASSES BEGIN QUARTERLY. - DRIVING WITH CARE 2: FOR THE FIRST TIME DWI OFFENDER WITH A BLOOD ALCOHOL LEVEL OF MORE THAN .15 AT THE TIME OF ARREST, OR MULTIPLE DWI OFFENCES. DRIVING WITH CARE 2 IS A GROUP EDUCATION AND TRAINING PROGRAM THAT HAS PROVEN TO REDUCE RECURRENCE OF DWI. NEW CLASSES BEGIN QUARTERLY.RATHER THAN EXPAND THE SCOPE OF MENTAL HEALTH SERVICES, RIVERVIEW WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS SUCH AS THE NORTHWESTERN MENTAL HEALTH CENTER TO ENSURE THE COMMUNITY HAS ADEQUATE ACCESS TO MENTAL HEALTH SERVICES.IN 2019 RIVERVIEW HEALTH PUBLISHED ITS THIRD CHNA REPORT. BASED ON THAT COMMUNITY HEALTH NEEDS ASSESSMENT, RIVERVIEW HEALTH IDENTIFIED OBESITY, INCLUDING JOINT/BACK PAIN AND HIGH BLOOD PRESSURE AS THE PRIMARY SIGNIFICANT COMMUNITY HEALTH NEED AND SUBSTANCE ABUSE AND MENTAL HEALTH AS THE SECONDARY SIGNIFICANT COMMUNITY HEALTH NEEDS.BETWEEN OCTOBER 2019 AND SEPTEMBER 2022, RIVERVIEW HEALTH TOOK THE FOLLOWING ACTIONS TO ADDRESS THE PREVIOUSLY IDENTIFIED COMMUNITY HEALTH NEEDS: OBESITY:RIVERVIEW HEALTH CONTINUES TO EMPLOY A LICENSED REGISTERED DIETICIAN (LRD) THAT FOCUSES ON THE HEALTHY EATING HABITS OF THE PATIENTS IN OUR COMMUNITY. THIS POSITION SERVED IN A CAPACITY FOR 1:1 CARE PLAN DEVELOPMENT AND GROUP EDUCATION AS WELL AS COMMUNITY PRESENTATIONS RELATING TO HEALTHY INTAKE AND WEIGHT/METABOLIC CONTROL. FREQUENCY OF REFERRALS FROM PROVIDERS FOR 1:1 COUNSELING WITH THE REGISTERED DIETICIAN HAS MORE THAN DOUBLED IN THE PAST THREE YEARS. AS AN INTEGRAL PART OF THE TEAM THE DIETICIAN WORKS WITH PROVIDERS AND HEALTH COACHES TO MANAGE THE HEALTH OF PATIENTS. RIVERVIEW HAS WORKED TOWARD IMPROVING PATIENTS THAT STRUGGLE WITH EATING HABITS AND WEIGHT CONTROL. THIS IMPROVEMENT IS SPECIFICALLY MEASURED THROUGH A GOAL THAT STATES: RIVERVIEW WILL IMPROVE OVERALL CONTROL OF ADULT DIABETIC PATIENT BLOOD SUGAR LEVELS TO AT LEAST 80% OF PATIENTS HAVING A HGBA1C MEASUREMENT OF LESS THAN 8%. RIVERVIEW HAS MET THE GOAL IN EACH YEAR SINCE INCEPTION. IN ADDITION TO EMPLOYING A REGISTERED DIETICIAN RIVERVIEW SPONSORS COMMUNITY EVENTS TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THE FOLLOWING LIST INCLUDES EXAMPLES:THE POWER OF PRODUCE: FOR THE PAST THREE YEARS RIVERVIEW HAS SPONSORED THE POWER OF PRODUCE TO PROVIDE FREE WHOLE FRUITS AND VEGETABLES TO KIDS AND SENIOR CITIZENS AT THE LOCAL FARMERS MARKET. RIVERVIEW 2K WALK AND ROLL: AN EVENT FOCUSED ON PROMOTING AND ENCOURAGING ACTIVITY AND MOVEMENT DIABETES SUPPORT GROUP: PEER GROUP THAT SUPPORTS AND PROMOTES HEALTHY ACTIVITIES AND HABITS. HEALTH HABITS COOKING VIDEOS: EXAMPLE - HTTPS://YOUTU.BE/UND3QJQZZFS MEDICAL MINUTE VIDEOS: EXAMPLE - HTTPS://YOUTU.BE/5R-ER6KCRZA SUBSTANCE ABUSE:RIVERVIEW CONTINUES TO OFFER SUBSTANCE ABUSE TREATMENT. TO INCREASE ACCESS TO TREATMENT, RIVERVIEW RECOVERY CENTER STARTED OFFERING ELECTRONIC OPTIONS FOR SERVICES. WITH THE USE OF A SMART PHONE OR TABLET CLIENTS CAN CONNECT WITH COUNSELORS FOR A VARIETY OF ASSESSMENT AND TREATMENT OPTIONS. THIS STRATEGY HAS DECREASED THE AMOUNT OF NO SHOWS FOR TREATMENT APPOINTMENTS AND ALLOWS THE CLIENT FLEXIBILITY FOR TREATMENT. TREATMENTS INCLUDE: COMPREHENSIVE HEALTH ASSESSMENTS: A COMPREHENSIVE CHEMICAL HEALTH ASSESSMENT. INDIVIDUAL COUNSELING SESSIONS: PROVIDED FOR INDIVIDUALS THAT HAVE COMPLETED TREATMENT AND ARE STRUGGLING WITH THOUGHTS OF USING. INTENSIVE OUTPATIENT TREATMENT: INTENSIVE OUTPATIENT THERAPY INCLUDES THREE GROUP COUNSELING MEETINGS PER WEEK. ONE WEEKLY INDIVIDUAL COUNSELING SESSION AND REGULAR URINE DRUG AND ALCOHOL SCREENING FOR INDIVIDUALS STRUGGLING WITH ADDICTION THAT DO NOT MEET THE CRITERIA FOR RESIDENTIAL TREATMENT. RELAPSE PREVENTION: RELAPSE PREVENTION INCLUDES ONE INDIVIDUAL COUNSELING SESSION PER WEEK AS WELL AS REGULAR URINE DRUG AND ALCOHOL SCREENING TESTS FOR INDIVIDUALS THAT HAVE COMPLETED TREATMENT, INPATIENT OR INTENSIVE OUTPATIENT, IN THE LAST THREE YEARS AND ARE STRUGGLING WITH ADDICTION. RELAPSE PREVENTION IS INTENDED FOR INDIVIDUALS THAT ARE NOT USING DAILY BUT WANT TO STOP THE CYCLE.DRIVING WITH CARE 1: FOR THE FIRST TIME DWI OFFENDER WITH A BLOOD ALCOHOL LEVEL OF LESS THAN .15 AT THE TIME OF ARREST. DRIVING WITH CARE 1 IS A GROUP EDUCATION AND TRAINING PROGRAM THAT HAS PROVEN TO REDUCE THE RECURRENCE OF DWI. NEW CLASSES BEGIN QUARTERLY. DRIVING WITH CARE 2: FOR THE FIRST TIME DWI OFFENDER WITH A BLOOD-ALCOHOL LEVEL OF MORE THAN .15 AT THE TIME OF ARREST, OR MULTIPLE DWI OFFENSES. DRIVING WITH CARE 2 IS A GROUP EDUCATION AND TRAINING PROGRAM THAT HAS PROVEN TO REDUCE THE RECURRENCE OF DWI. NEW CLASSES BEGIN QUARTERLY. MENTAL HEALTH:RIVERVIEW CONTINUES TO PARTNER WITH ALLUMA (FORMERLY NORTHWESTERN MENTAL HEALTH) TO ENSURE THE COMMUNITY HAS ADEQUATE ACCESS TO MENTAL HEALTH SERVICES. SOME OF THE COLLABORATIONS WITH ALLUMA INCLUDE: SUICIDE PREVENTION RIVERVIEW HEALTH FOCUSES ON SUICIDE PREVENTION, MENTAL HEALTH, AND MENTAL WELLNESS. RIVERVIEW HEALTH HAS A SUICIDE PREVENTION STEERING COMMITTEE UTILIZING THE ZERO SUICIDE INITIATIVE. RIVERVIEW PARTNERS WITH THE MINNESOTA DEPARTMENT OF HEALTH AND ALLUMA WITH THE ZERO SUICIDE INITIATIVE ACTION PLAN. CRISIS TEAM ALLUMA HAS A CRISIS RESPONSE TEAM THAT WILL RESPOND TO OUR EMERGENCY DEPARTMENT IF A NEED ARISES. THE CRISIS RESPONSE TEAM ALLOWS FOR GREATER CARE COORDINATION AND ENSURES THE PATIENTS HAVE ACCESS TO THE SERVICES THEY NEED. RIVERVIEW HOSPITAL PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTNACE POLICY IS AVAILABLE AT:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/RIVERVIEW-HEALTH-SITE-275/MEDIA/3D66C20A22744620A988C9626281EC69/2023-COMMUNITY-CARE-APPLICATION-FULL.PDFTHE FINANCIAL ASSISTANCE POLICY APPLICATION IS AVAILABLE AT:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/RIVERVIEW-HEALTH-SITE-275/MEDIA/3D66C20A22744620A988C9626281EC69/2023-COMMUNITY-CARE-APPLICATION-FULL.PDFTHE FINANCIAL ASSITANCE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/RIVERVIEW-HEALTH-SITE-275/MEDIA/3D66C20A22744620A988C9626281EC69/2023-COMMUNITY-CARE-APPLICATION-FULL.PDF 11 1 - RIVERVIEW CLINIC CROOKSTON 323 S MINNESOTA STREET CROOKSTON MN 56716 OUTPATIENT CLINIC 2 - RIVERVIEW CLINIC EAST GRAND FORKS 1428 CENTRAL AVENUE NE EAST GRAND FORKS MN 56721 OUTPATIENT CLINIC/REHAB 3 - RIVERVIEW CLINIC FERTILE 306 N MILL STREET FERTILE MN 56540 OUTPATIENT CLINIC 4 - RIVERVIEW CLINIC RED LAKE FALLS 105 INTERNATIONAL DRIVE RED LAKE FALLS MN 56750 OUTPATIENT CLINIC/REHAB 5 - RIVERVIEW CLINIC THIEF RIVER FALLS 1140 VANROOY DRIVE THIEF RIVER FALLS MN 56701 OUTPATIENT CLINIC 6 - RIVERVIEW CARE CENTER 323 S MINNESOTA STREET CROOKSTON MN 56716 NURSING HOME 7 - RIVERVIEW HOME CARE 721 S MINNESOTA STREET CROOKSTON MN 56716 HOME HEALTH 8 - RIVERVIEW RECOVERY CROOKSTON 721 S MINNESOTA STREET CROOKSTON MN 56716 OUTPATIENT CHEMICAL DEPENDENCY 9 - RIVERVIEW RECOVERY EAST GRAND FORKS 210 GATEWAY DRIVE NE SUITE 3 EAST GRAND FORKS MN 56721 OUTPATIENT CHEMICAL DEPENDENCY 10 - RIVERVIEW RECOVERY ROSEAU 216 CENTER STREET W 101 ROSEAU MN 56751 OUTPATIENT CHEMICAL DEPENDENCY 11 - RIVERVIEW RECOVERY THIEF RIVER FALLS 213 NORTH LEBREE AVE SUITE 100 THIEF RIVER FALLS MN 56701 OUTPATIENT CHEMICAL DEPENDENCY PART I, LINE 3C: ELIGIBILITY FOR CHARITY CARE IS BASED ON HOUSEHOLD INCOME COMPARED TO FEDERAL POVERTY GUIDELINES FOR THE INDIVIDUAL'S FAMILY SIZE. TO QUALIFY FOR CHARITY CARE, A PERSON MUST RECEIVE MEDICALLY NECESSARY CARE AT RIVERVIEW HOSPITAL AND CLINICS, BE A RESIDENT OF EITHER MINNESOTA OR NORTH DAKOTA, SUBMIT A COMPLETE CHARITY CARE APPLICATION INCLUDING REQUIRED DOCUMENTATION, AND SUBMIT EVIDENCE OF APPLICATION FOR GOVERNMENT MEDICAL ASSISTANCE. PART I, LINE 7: COSTS INCLUDED ON LINES 7A AND 7B ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS SCHEDULE H INSTRUCTIONS. THE COSTS REPORTED ON LINES 7E-7I ARE DIRECT COSTS TO THE FACILITIES FOR THE PROGRAMS DESCRIBED BELOW. PART 1, LINE 7E COSTS: COMMUNITY HEALTH SERVICES IS THE TOTAL COST OF ACTIVITIES TO IMPROVE COMMUNITY HEALTH IN THE FOLLOWING AREAS: (1)PROVIDING COMMUNITY HEALTH EDUCATION WITH HEALTH LECTURES AND WORKSHOPS TO COMMUNITIY GROUPS, HEALTH AND CAREER DAY FAIRS, FAMILY AND FRIENDS CPR CLASSES AND BY PROVIDING SPECIFIC DIAGNOSES (AUTISM) SUPPORT GROUPS; (2) PROVIDING CLINICAL SERVICES SUCH AS FREE BLOOD PRESSURE AND CHOLESTEROL SCREENING AT HEALTH FAIRS; AND (3) PROVIDING SUPPORT SERVICES LIKE ENROLLMENT ASSISTANCE IN PUBLIC PROGRAMS, MENTAL HEALTH SERVICE HOT-LINES AND BUS TRANSPORTATION VOUCHERS TO ENHANCE PATIENT ACCESS TO CARE.PART I, LINE 7F COSTS: HEALTH PROFESSIONS EDUCATION IS THE COST OF OPERATING PROFESSIONAL EDUCATION AND TRAINING PROGRAMS FOR MEDICAL STUDENTS, NURSING STUDENTS, AND TECHNICIANS. SCHOLARSHIPS ARE ALSO OFFERED TO NON-EMPLOYEES FOR NURSING AND OTHER PROFESSIONAL EDUCATION. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HEALTH CARE ORGANIZATION. CLINICAL PATIENT CARE SERVICES ARE PROVIDED DESPITE A NEGATIVE MARGIN BECAUSE THEY ARE NEEDED BY THE COMMUNITY THE HOSPITAL'S SUBSIDIZED HEALTH SERVICES INCLUDE THE HOSPITAL OPERATED CLINIC. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,353,743. PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE ASSOCIATION 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 ASSOCIATION 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 ASSOCIATION RECORDS A 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. PART III, LINE 3: ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANT POLICY WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE AND MULTIPLYING IT BY THE RATIO OF THE ORGANIZATION'S MEDICAID CONTRACTUAL ADJUSTMENTS TO THE TOTAL PATIENT SERVICE REVENUE AMOUNTS FROM THE HAR REPORT. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT RECEIVABLES, NET NOTE ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINE 6 WERE DERIVED FROM THE 2021 FILED MEDICARE COST REPORT. PART III, LINE 9B: THROUGHOUT THE PAYMENT AND COLLECTION PROCESS, STAFF ATTEMPTS TO IDENTIFY TO THE EXTENT POSSIBLE, PATIENTS WHICH ARE WORTHY AND APPROPRIATE FOR CHARITY CONSIDERATION. THOSE ACCOUNTS TO BE CONSIDERED FOR CHARITY REDUCTIONS ARE ASKED TO COMPLETE A FINANCIAL DISCLOSURE FORM, WHICH WILL PROVIDE PERTINENT PATIENT FINANCIAL INFORMATION NECESSARY TO DETERMINE FINANCIAL NEED. REVIEW OF POTENTIAL CHARITY REQUESTS ARE PERFORMED DAILY BY THE FINANCIAL COORDINATOR AND CERTAIN RECOMMENDATIONS ARE FORWARDED TO THE CFO FOR SIGNATURE AND APPROVAL. ALL MINNESOTA RESIDENTS, UPON REQUEST, WHO ARE UNINSURED WILL RECEIVE A PRIVATE PAY DISCOUNT DETERMINED BY THE INSURANCE COMPANY WITH WHICH RIVERVIEW HEALTH DOES THE GREATEST VOLUME. THE SOCIAL SERVICES DEPARTMENT OF RIVERVIEW HEALTHCARE WORKS CLOSELY WITH THE STATE MEDICAID ELIGIBILITY PROGRAM TO ENSURE PATIENTS HAVE ACCESS TO AVAILABLE PROGRAMS. NON-INSURED PATIENTS ARE REFERRED TO THE STATE MEDICAID ELIGIBILITY PROGRAM FOR A PROBABILITY OF ELIGIBILITY ASSESSMENT. PART VI, LINE 2: THE HOSPITAL PERFORMED PATIENT SURVEYS AND HIRED CONSULTANTS THAT PERFORM SURVEYS AND STUDIES TO DETERMINE HEALTH CARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: CHARITY CARE FORMS ARE HANDED OUT IN ADMITTING AND ALSO PLACED IN COLLECTION LETTERS. MEDICAID SERVICES INFORMATION IS AVAILABLE TO PATIENTS AT REGISTRATION. THE MULTI-DISCIPLINARY DISCHARGE PLANNING COMMITTEE MEETS DAILY AND PLANS THE DISCHARGE OF PATIENTS, INCLUDING FINNANCIAL PLANNING. REFER TO APPROPRIATE AGENCIES AND PROGRAMS FOR FINANCIAL AID WHEN THE PATIENT HAS NO HOSPITAL INSURANCE OR WHEN PATIENT/FAMILY RESOURCES ARE LIMITED OR DEPLETED. PART VI, LINE 4: RIVERVIEW HEALTH PRIMARY SERVICE AREA CONSISTS OF POLK & RED LAKE COUNTY WITH A POPULATION OF APPROXIMATELY 34,700. THE UNEMPLOYMENT RATE IS BELOW THE STATE LEVEL. THE MAJORITY OF WORKERS ARE EMPLOYED IN HEALTHCARE, MANUFACTURING OR FARMING.POLK AND RED LAKE COUNTIES HAVE A LARGER-THAN-AVERAGE PROPORTION OF ELDERLY INDIVIDUALS POLK AND RED LAKE COUNTIES HAVE A MEDIAN INCOME BELOW STATE AVERAGE. PART VI, LINE 5: COMMUNITY BUILDING ACTIVITIES ARE PROGRAMS AND ACTIVITIES THAT ARE DESIGNED TO ADDRESS ROOT CAUSES OF HEALTH PROBLEMS IN THE COMMUNITY. DISASTER READINESS, REDUCING THE AIR ENVIRONMENTAL HAZARDS, SHARPS DISPOSAL AND COMMUNITY LEADERSHIP DEVELOPMENT ARE SOME PROGRAMS. RECRUITMENT OF PHYSICIANS TO THIS RURAL COMMUNITY AND PROVIDING PROGRAMS TO DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE ARE TWO OTHER ACTIVITIES. PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X X X 0 0 0 0 0 0 0 0 0 DR COLIN FENNELL PHYSICIAN 887466 0 0 0 0 0 15950 0 27654 0 931070 0 0 0 DR OLATUBOSUN FASHORO PHYSICIAN / CHIEF OF STAFF 862408 0 0 0 0 0 15950 0 29561 0 907919 0 0 0 DR SUNNY KIM PHYSICIAN 898819 0 0 0 0 0 0 0 0 0 898819 0 0 0 DR HAMID ABBASI PHYSICIAN 891823 0 0 0 0 0 0 0 0 0 891823 0 0 0 DR RAM PANERU PHYSICIAN 784454 0 0 0 0 0 15950 0 29555 0 829959 0 0 0 DR ERIK KANTEN TRUSTEE/PHYSICIAN 655230 0 0 0 0 0 15950 0 28975 0 700155 0 0 0 DR BRETT VIBETO TRUSTEE/PHYSICIAN 460281 0 0 0 0 0 15950 0 13715 0 489946 0 0 0 CARRIE MICHALSKI PRESIDENT & CEO 303170 0 0 0 0 0 15950 0 29224 0 348344 0 0 0 BETTY ARVIDSON CFO / VP OF FINANCE 168860 0 0 0 0 0 9642 0 21558 0 200060 0 0 0 CHRIS BRUGGEMAN COO / VP OF OPERATIONS 153381 0 0 0 0 0 9151 0 31806 0 194338 0 0 0 APRIL GRUNHOVD CNO / VP OF PATIENT SERVIC 177783 0 0 0 0 0 9849 0 2067 0 189699 0 0 0 LANCE NORMAN VP OF ANCILLARY SERVICES 161881 0 0 0 0 0 9124 0 14454 0 185459 0 0 0 JEAN TATE VP OF HUMAN RESOURCES 135599 0 0 0 0 0 7791 0 14291 0 157681 0 0 0 A CITY OF CROOKSTON MN 416005076 227235AV0 2017-09-21 10000000 REFUND SERIES 2007 BONDS 0 0 0 B CITY OF CROOKSTON MN 416005076 227235BL1 2019-04-24 48166705 FACILITY CONSTRUCTION 0 0 0 A 1235000 10000000 1403642 267958 8832997 1 0 1 1 B 2001705 48166705 4015135 1118209 43033361 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 A 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART IV, LINE 12B FINALIZED AUDITED FINANCIAL STATEMENTS WERE NOT AVAILABLE AS OF THE RETURN PREPARATION DATE. NON-FINALIZED FINANCIAL STATEMENTS FROM CLIFTONLARSONALLEN WERE ATTACHED TO THE RETURN. FORM 990, PART VI, SECTION A, LINE 1A ALL OF THE OFFICERS OF THE HOSPITAL AND SUCH OTHER PERSONS, IF ANY, ELECTED BY THE BOARD OF DIRECTORS BY RESOLUTION SHALL CONSTITUTE THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF THE HOSPITAL. THE EXECUTIVE COMMITTEE SHALL ACT ONLY DURING INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS. DURING SUCH INTERVALS AND SUBJECT TO SUCH CONTROL AND DIRECTION, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY AND POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE HOSPITAL, SUBJECT TO SUCH LIMITATIONS AS THE BOARD OF DIRECTORS MAY IMPOSE. THE EXECUTIVE COMMITTEE SHALL KEEP REGULAR MINUTES OF ITS PROCEEDINGS AND REPORT THE SAME TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 RIVERVIEW HEALTHCARE SHALL HAVE VOTING MEMBERS WHO MUST BE 18 YEARS OF AGE OR OLDER, PAY THE MEMBERSHIP FEE DETERMINED BY THE BOARD, MUST LIVE WITHIN 30 MILES OF THE COMMUNITIES SERVED BY RIVERVIEW AND AGREE TO ABIDE BY THE ARTICLES OF INCORPORATION, BYLAWS AND OTHER RULES OF THE HOSPITAL. ANY MEMBER WHO FAILS TO PAY ANY DUES OR ASSESSMENT MAY, AFTER REASONABLE NOTICE, HAVE HIS OR HER MEMBERSHIP CANCELLED. FORM 990, PART VI, SECTION A, LINE 7A RIVERVIEW HEALTHCARE'S BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THEIR ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B ANY AMENDMENTS MADE TO RIVERVIEW HEALTHCARE'S ARTICLES OF INCORPORATION OR BYLAWS MUST BE APPROVED BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 WAS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND THE ACCOUNTING MANAGER FOR ACCURACY AND COMPLETENESS. AT THIS TIME THE FORM 990 WAS PRESENTED TO THE AUDIT AND FINANCE COMMITTEE. UPON APPROVAL, THE FORM 990 WAS SHARED ELECTRONICALLY WITH THE BOARD MEMBERS PRIOR TO A REGULARLY SCHEDULED BOARD MEETING AT WHICH THE BOARD MEMBERS APPROVED THE RETURN PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTERESTS POLICY SERVES TO PROTECT THE INTEGRITY OF ASSOCIATION INFORMATION, PRODUCTS, SERVICES AND EMPLOYEE EFFORTS. EMPLOYEES ARE EXPECTED TO DEVOTE THEIR BEST EFFORTS AND BE LOYAL TO THE INTERESTS OF RIVERVIEW HEALTH. RIVERVIEW RECOGNIZES THE RIGHT OF EMPLOYEES TO ENGAGE IN ACTIVITIES OUTSIDE OF THEIR EMPLOYMENT HERE, WHICH ARE OF A PRIVATE NATURE AND UNRELATED TO OUR BUSINESS. HOWEVER, A POLICY OF FULL DISCLOSURE WILL BE FOLLOWED TO ASSESS AND PREVENT POTENTIAL CONFLICTS OF INTERESTS FROM ARISING. 1. EMPLOYEES ARE NOT PERMITTED TO ENGAGE IN ACTIVITIES THAT ARE IN COMPETITION WITH THE BUSINESS ACTIVITIES OF RIVERVIEW HEALTH (EXAMPLES MAY INCLUDE, BUT ARE NOT LIMITED TO, REHAB SERVICES, CD COUNSELING, HOME CARE, OUTSIDE CONSULTATION SERVICES SUCH AS PHARMACY OR DIETETICS, OR OTHER REVENUE PRODUCING AREAS). 2. EMPLOYEES MUST DISCLOSE IN FULL, AT TIME OF EMPLOYMENT AND ANNUALLY THEREAFTER, ANY ACTIVITY THAT THEY ENGAGE IN THAT IS SIMILAR IN NATURE OR IN DIRECT COMPETITION WITH A SERVICE OF RIVERVIEW HEALTH. 3. NO EMPLOYEE MAY ENGAGE IN OUTSIDE WORK THAT WILL INTERFERE WITH HIS OR HER PRIMARY JOB WITH RIVERVIEW HEALTH. THERE IS AN EXPECTATION OF A DUTY OF LOYALTY BY ALL EMPLOYEES. 4. NO EMPLOYEE MAY ACCEPT PAYMENT, RETAINER, COMMISSION, CONSULTING FEE OR ENTER INTO ANY OTHER FEE ARRANGEMENT OR REMUNERATIONS FOR SERVICES PROVIDED IN CONJUNCTION WITH RIVERVIEW HEALTH OTHER THAN THEIR NORMAL WAGES WITHOUT THE EXPRESS APPROVAL OF ADMINISTRATION. 5. NO OUTSIDE WORK MAY BE DONE DURING ANY EMPLOYEES WORK HOURS. ASSOCIATION FACILITIES, EQUIPMENT, LABOR OR SUPPLIES MAY NOT BE USED TO CONDUCT NON-RIVERVIEW HEALTH BUSINESS WITHOUT THE EXPRESS APPROVAL OF ADMINISTRATION. 6. EMPLOYEES MUST DISCLOSE ANY MATERIAL FINANCIAL OR OTHER BENEFICIAL INTEREST IN ANY ENTITY ENGAGED IN THE DELIVERY OF HEALTH CARE SERVICES. 7. EMPLOYEES MUST DISCLOSE ANY MATERIAL FINANCIAL OR OTHER BENEFICIAL INTEREST IN ANY ENTITY ENGAGED IN THE DELIVERY OF GOODS AND SERVICES TO RIVERVIEW HEALTH. 8. FAILURE TO DISCLOSE INFORMATION RELATED TO ANY OF THE ABOVE POINTS TO ADMINISTRATION MAY LEAD TO CORRECTIVE ACTION UP TO AND INCLUDING DISCHARGE. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES ANNUALLY SIGN A CONFLICT OF INTEREST FORM. IF A CONFLICT OF INTEREST EXISTS, THE CONFLICTED PERSON ABSTAINS FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE RIVERVIEW HEALTHCARE ASSOCIATION BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO. ANNUALLY, THE BOARD OF DIRECTORS RECEIVES COMPENSATION SURVEYS FROM HRAM AND THE MINNESOTA HOSPITAL ASSOCIATION AND USES THESE TO SET THE COMPENSATION FOR THE CEO. SIMILAR METHODS ARE USED TO SET THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. HOWEVER, THE COMPENSATION IS REVIEWED AND APPROVED BY THE ADMINISTRATION OFFICERS AND HUMAN RESOURCES. THESE PROCESSES ARE COMPLETED ANNUALLY IN JANUARY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 11G MEDICAL SERVICES FEES: PROGRAM SERVICE EXPENSES 7,148,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,148,841. OTHER SERVICE FEES: PROGRAM SERVICE EXPENSES 911,171. MANAGEMENT AND GENERAL EXPENSES 1,663,762. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,574,933. FORM 990, PART XII, LINE 2C: THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. RIVERVIEW HEALTHCARE FOUNDATION 323 SOUTH MINNESOTA STREET CROOKSTON MN 56716 411699589 FUNDRAISING MN 501(C)(3) LINE 7 RIVERVIEW HEALTHCARE ASSOCIATION 1 GLENMORE FOUNDATION 323 SOUTH MINNESOTA STREET CROOKSTON MN 56716 411112748 CHEMICAL DEPENDENCY FINANCIAL ASSISTANCE MN 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 RIVERVIEW HEALTHCARE FOUNDATION C 150671 CASH GLENMORE FOUNDATION C 18314 CASH