2025-08-11T16:37:59-05:00 2024-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2023-10-01 410745522 AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER AITK 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 CASEY JOHNSON CFO 2189272121 2025-08-10 1 0 JULIE BOYER P01278549 2187275025 2025-08-10 2023 2025-03-06 01:10:19Z KEN WESTMAN 200 BUNKER HILL DRIVE AITKIN MN 56431 124935527 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 10 605 103 663011 0 1620461 683121 92703428 101971501 305703 665989 1468685 1305826 96098277 104626437 130111 184072 0 0 45063758 48027830 0 0 0 49524206 58661333 94718075 106873235 1380202 -2246798 133201757 172276125 55455320 96324782 77746437 75951343 X TO IMPROVE HEALTH BY PROVIDING HIGH QUALITY, COMPASSIONATE AND PERSONALIZED CARE. 0 0 91846734 184072 102968699 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.IN 2024, RIVERWOOD CONTINUED TO USE DIGITAL TECHNOLOGY TO ENHANCE PATIENT CARE, INCLUDING CONTINUING TELEMEDICINE VIRTUAL VISITS FOR PRIMARY CARE AND SPECIALTY CARE, AND TAPPING VIRTUAL RESOURCES FOR INPATIENT CARE AS WELL. VIRTUAL RESOURCES OFFER GREATER CONVENIENCE FOR THOSE WHO FIND IT DIFFICULT TO GET AWAY FROM THEIR JOB, FIND THE TIME TO TRAVEL TO THEIR CLINIC FOR AN IN-PERSON EXAM OR WHEN WEATHER CONDITIONS MAKE IT UNSAFE TO TRAVEL. DR. TIM ARNOLD SAID, "FROM A PROVIDER PERSPECTIVE, THE VIRTUAL VISIT GIVES US A NEW WAY TO CARE FOR OUR PATIENTS THAT IS MUCH BETTER THAN A PHONE VISIT. WE STILL LIKE TO BE ABLE TO SEE PATIENTS IN THE CLINIC, BUT THIS IS A GREAT OPTION FOR BOTH PROVIDERS AND PATIENTS." RIVERWOOD RECEIVED SEVERAL HOSPITAL DESIGNATIONS IN 2024. THE CENTERS OF MEDICARE AND MEDICAID RELEASED ITS HOSPITAL COMPARE REPORT SHOWING HOW HOSPITALS ACROSS THE NATION ARE PERFORMING. RIVERWOOD HEALTHCARE CENTER EARNED A FIVE-STAR RATING FOR THE LAST REPORTING PERIOD COVERING OCTOBER 2022 THROUGH SEPTEMBER 2023. STAR RATINGS OFFER VALUABLE INSIGHTS TO HELP INDIVIDUALS COMPARE HOSPITALS LOCALLY AND NATIONWIDE. THESE RATINGS, BASED ON A FIVE-STAR SCALE, PROVIDE A SNAPSHOT OF HOSPITAL PERFORMANCE ACROSS MEASURES INCLUDING MORTALITY AND READMISSION RATES, EMERGENCY DEPARTMENT TREATMENT, AND VALUE OF CARE. RIVERWOOD'S HOSPITAL RECEIVED FIVE STARS FOR THE PATIENT STAR RATING, WHICH IS BASED ON SURVEY RATINGS OF RECENTLY DISCHARGED HOSPITAL PATIENTS, MEASURING VARIOUS EXPERIENCE ITEMS SUCH AS COMMUNICATION, STAFF RESPONSIVENESS, CLEANLINESS, QUIETNESS, CARE TRANSITION AND OVERALL PATIENT EXPERIENCE. IN MAY 2024, THE MINNESOTA HOSPITAL ASSOCIATION (MHA) AWARDED RIVERWOOD HEALTHCARE CENTER WITH THE HIGH RELIABILITY ORGANIZATION AWARD. THIS AWARD RECOGNIZES EFFORTS TO IMPROVE QUALITY AND SAFETY. WITH AN OVERRIDING OBJECTIVE FOR "ZERO HARM" RIVERWOOD EMPLOYEES ARE STRONGLY COMMITTED TO ACHIEVING SAFETY, QUALITY, AND EFFICIENCY GOALS. CHIEF NURSING OFFICER CARLA ZUPKO, WHO ACCEPTED THE AWARD FOR RIVERWOOD, COMMENTS: "THIS STATEWIDE RECOGNITION IS A TRIBUTE TO THE PROGRESS OUR ORGANIZATION HAS MADE OVER THE PAST FEW YEARS. RIVERWOOD HAS MADE SIGNIFICANT STRIDES IN IMPROVING QUALITY AND SAFETY FOR OUR PATIENTS AS WE STRIVE FOR ZERO HARM." EXAMPLES INCLUDE THE DISTRIBUTION OF KEY SAFETY MEASURES COMMUNICATED THROUGH MONTHLY TALKING POINTS FOR ALL STAFF MEMBERS, REGULAR TEAM DISCUSSIONS ON SAFETY ISSUES, AND THE USE OF A QUALITY DASHBOARD TO HELP IDENTIFY AND GUIDE AREAS FOR IMPROVEMENT. ZUPKO ADDS: "WE ROLLED OUT AN EIGHT-STEP CONTINUOUS PROCESS IMPROVEMENT MODEL AND OUR STAFF COMPLETED MORE THAN 19 FACILITATED CPI EVENTS IN THE PAST TWO YEARS TO HELP DEPARTMENTS STREAMLINE PROCESSES, ELIMINATE WASTE AND INCREASE SAFETY." RIVERWOOD HEALTHCARE CENTER EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ACCREDITATION FOR ITS LABORATORY SERVICES BY DEMONSTRATING CONTINUOUS COMPLIANCE WITH ITS PERFORMANCE STANDARDS. THE GOLD SEAL IS A SYMBOL OF QUALITY THAT REFLECTS A HEALTH CARE ORGANIZATION'S COMMITMENT TO PROVIDING SAFE AND QUALITY PATIENT CARE. RIVERWOOD UNDERWENT A RIGOROUS, UNANNOUNCED ONSITE REVIEW NOV. 14-16, 2023. DURING THE VISIT, A TEAM OF JOINT COMMISSION REVIEWERS EVALUATED COMPLIANCE WITH CRITICAL ACCESS HOSPITAL STANDARDS SPANNING LABORATORY SERVICES. THE JOINT COMMISSION'S STANDARDS ARE DEVELOPED IN CONSULTATION WITH HEALTH CARE EXPERTS AND PROVIDERS, MEASUREMENT EXPERTS AND PATIENTS. THEY ARE INFORMED BY SCIENTIFIC LITERATURE AND EXPERT CONSENSUS TO HELP HEALTH CARE ORGANIZATIONS MEASURE, ASSESS, AND IMPROVE PERFORMANCE. THE SURVEYORS ALSO CONDUCTED ONSITE OBSERVATIONS AND INTERVIEWS. RIVERWOOD CEO KEN WESTMAN COMMENTS: "IN PREPARATION FOR JOINT COMMISSION ACCREDITATION, RIVERWOOD MAINTAINS STRONG LEVELS OF SAFETY AND QUALITY ACROSS ALL SERVICES THROUGH FREQUENT INTERNAL MONITORING AND ASSESSMENTS. OUR STAFF CONTINUALLY IMPROVES PERFORMANCE WITHIN A SAFETY CULTURE, KEEPING THE PATIENT AT THE CENTER OF CARE DELIVERY AND SEEKING IMPROVEMENT AT EVERY OPPORTUNITY." IN 2024 RIVERWOOD HEALTHCARE CENTER WAS RECOGNIZED AS 2024 HUMAN EXPERIENCE GUARDIAN OF EXCELLENCE AWARD WINNER ALONG WITH OTHER HEALTHCARE ORGANIZATIONS NATIONWIDE. THIS AWARD IS GIVEN THROUGH PRESS GANEY, A GLOBAL LEADER IN HEALTHCARE EXPERIENCE SOLUTIONS AND SERVICES. THIS AWARD IS PART OF PRESS GANEY'S ANNUAL RANKING OF THE TOP HOSPITALS AND HEALTH SYSTEMS IN THE COUNTRY, ACCORDING TO PERFORMANCE IN PATIENT SATISFACTION. AS A WINNER OF THIS AWARD, RIVERWOOD SCORED IN THE TOP 5 PERCENT OF PRESS GANEY HEALTHCARE PROVIDERS FOR PATIENT EXPERIENCE BASED ON ONE YEAR OF DATA. RIVERWOOD CEO KEN WESTMAN SAID: "THANKS TO ALL OUR RIVERWOOD TEAM MEMBERS FOR THEIR UNWAVERING COMMITMENT TO OUR MISSION TO IMPROVE HEALTH BY PROVIDING HIGH-QUALITY, COMPASSIONATE, AND PERSONALIZED CARE. THE SURVEY DATA COLLECTED BY PRESS GANEY GIVES US GREATER INSIGHT INTO HOW WE CAN CONTINUE TO RAISE THE BAR TO TAKE CARE OF THE COMMUNITIES WE SERVE. CONNECTING ALL THE DOTS ACROSS PEOPLE, PROCESSES AND TECHNOLOGY HELPS DRIVE MEANINGFUL CHANGE IN CARE DELIVERY, PUTTING HUMAN EXPERIENCE AT THE HEART OF HEALTH CARE." PRESS GANEY IS THE LEADING HUMAN EXPERIENCE (HX) HEALTHCARE PERFORMANCE IMPROVEMENT COMPANY, OFFERS AN INTEGRATED SUITE OF SOLUTIONS THAT ADDRESS SAFETY, CLINICAL EXCELLENCE, PATIENT EXPERIENCE AND WORKFORCE ENGAGEMENT. THE COMPANY WORKS WITH MORE THAN 41,000 HEALTHCARE FACILITIES IN ITS MISSION TO REDUCE PATIENT SUFFERING AND ENHANCE CAREGIVER RESILIENCE TO IMPROVE THE OVERALL SAFETY, QUALITY, AND EXPERIENCE OF CARE. THE MINNESOTA DEPARTMENT OF HEALTH CONTINUES TO RECOGNIZE RIVERWOOD HEALTHCARE CENTER AS A LEVEL III TRAUMA HOSPITAL. AFTER PARTICIPATING IN AN INTENSE TRAINING PROCESS TO BECOME PART OF MINNESOTA'S STATEWIDE TRAUMA SYSTEM, THE AITKIN COUNTY HOSPITAL EARNED ITS INITIAL DESIGNATION IN DECEMBER 2006 AND WAS THE FIRST RURAL HOSPITAL IN MINNESOTA TO ACHIEVE THE LEVEL III DESIGNATION. "RIVERWOOD HAS A STRONG COMMITMENT TO CARING FOR TRAUMA PATIENTS WHERE RAPID MEDICAL RESPONSE IS CRITICAL TO SAVING LIVES," SAYS DR. JIM HARRIS, RIVERWOOD EMERGENCY DEPARTMENT MEDICAL DIRECTOR AND TRAUMA PROGRAM MEDICAL DIRECTOR. "THROUGH THE STATEWIDE TRAUMA SYSTEM, WE PARTICIPATE IN CONTINUOUS PERFORMANCE IMPROVEMENT ACTIVITIES AND STAFF TRAINING, ENSURING THAT ALL OUR ED NURSES AND PHYSICIANS ARE RE-CERTIFIED IN ADVANCED LIFESAVING AND TRAUMA CARE ANNUALLY. CONGRATULATIONS TO OUR RIVERWOOD TEAM FOR THIS BIG ACHIEVEMENT OF CONTINUOUS TRAUMA CENTER DESIGNATION OVER 17 YEARS." THE MINNESOTA TRAUMA SYSTEM FEATURES FOUR LEVELS OF CARE WITH VARYING DEGREES OF RESOURCES AVAILABLE AT HOSPITALS. LEVELS I AND II HOSPITALS HAVE THE MOST TRAUMA CARE RESOURCES. THESE ARE TYPICALLY HIGH-VOLUME TRAUMA CENTERS WITH SURGICAL SUBSPECIALTIES IMMEDIATELY AVAILABLE AT THE HOSPITAL. LEVEL III AND LEVEL IV HOSPITALS DEMONSTRATE A COMMITMENT TO PROVIDING HIGH QUALITY TRAUMA CARE WITH RESPECT TO THE RESOURCES THEY HAVE AVAILABLE. LEVEL III TRAUMA CENTERS HAVE SURGEONS READILY AVAILABLE TO THE HOSPITAL BUT LACK OTHER SURGERY SUBSPECIALTIES. LEVEL IV HOSPITALS DO NOT REQUIRE SURGERY SERVICES. FOR A SEVERELY INJURED PERSON, THE TIME BETWEEN SUSTAINING AN INJURY AND RECEIVING DEFINITIVE CARE IS THE MOST IMPORTANT PREDICTOR OF SURVIVALCALLED THE "GOLDEN HOUR." THE CHANCE OF SURVIVAL DIMINISHES WITH TIME. A STRONG LOCAL TRAUMA CENTER ENHANCES THE CHANCE OF SURVIVAL, REGARDLESS OF PROXIMITY TO AN URBAN HOSPITAL OFFERING A HIGHER LEVEL OF TRAUMA CARE. "INJURY IS A LEADING CAUSE OF PREMATURE DEATH IN MINNESOTA," SAID MINNESOTA COMMISSIONER OF HEALTH DR. BROOKE CUNNINGHAM. "THE GOAL OF THE TRAUMA SYSTEM IS TO DECREASE INJURED PATIENTS' TIME TO CARE BY MAKING SURE THEIR MEDICAL NEEDS ARE APPROPRIATELY MATCHED WITH HOSPITAL RESOURCES." ON AVERAGE, TRAUMA CLAIMS THE LIVES OF 4,300 MINNESOTANS ANNUALLY. STATES WITH TRAUMA SYSTEMS HAVE SEEN SURVIVAL RATES INCREASE BY 15 TO 20 PERCENT. WIDE-SCALE PARTICIPATION IN THE VOLUNTARY TRAUMA SYSTEM ENSURES THAT A STATEWIDE, COOPERATIVE EFFORT IS IN PLACE TO CARE FOR SERIOUSLY INJURED PATIENTS. RIVERWOOD HEALTHCARE CENTER WAS RECOGNIZED BY THE MINNESOTA HOSPITAL ASSOCIATION (MHA) FOR ONE OF THE OUTSTANDING COMMUNITY PROGRAMS IN MINNESOTA WITH ITS RIVERWOOD CONNECTS PROGRAM. RIVERWOOD HEALTHCARE CENTER WAS RECOGNIZED BY THE MINNESOTA HOSPITAL ASSOCIATION (MHA) FOR ONE OF THE OUTSTANDING COMMUNITY PROGRAMS IN MINNESOTA WITH ITS RIVERWOOD CONNECTS PROGRAM. 91846734 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 73 0 1 605 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 MN X JUDY TURNER 2189272121 200 BUNKER HILL DRIVE AITKIN MN 56431 DR JEFFREY EHNSTROM DIRECTOR/PHYSICIAN 40.00 X 424905 0 56168 DR TIMOTHY DIRKS DIRECTOR 1.00 X 0 0 0 HEATHER HIPP DIRECTOR 1.00 X 0 0 0 TOM LUNDBERG DIRECTOR 1.00 X 0 0 0 JARED LUNDGREN DIRECTOR 1.00 X 0 0 0 BRYAN NISTLER DIRECTOR 1.00 X 0 0 0 STEVE WILSON DIRECTOR 1.00 X 0 0 0 LOWELL LARSON SECRETARY 1.00 X X 0 0 0 CHAD GROSS TREASURER 1.00 X X 0 0 0 CHRISTINE BRIGHT VICE CHAIR 1.00 X X 0 0 0 MIKE PAULBECK VICE CHAIR (UNTIL 06/2024) 1.00 X X 0 0 0 KATHLEEN RYAN CHAIR 1.00 X X 0 0 0 KEN WESTMAN CEO 38.00 2.00 X 431489 0 52860 CASEY JOHNSON CFO 38.00 2.00 X 216793 0 44598 DR DAVID TAYLOR CMO 40.00 X 613302 0 50007 CYNTHIA BAKER COO 38.00 2.00 X 229257 0 46792 DR JIM HARRIS ER PHYSICAN 40.00 X 420478 0 49645 DR JESSICA HODSON ER PHYSICAN 40.00 X 402734 0 59168 ROBERT SCHMIEG CRNA 40.00 X 381001 0 44114 DR CHRISTOPHER HUGHES PROVIDER 40.00 X 357421 0 51655 DR MELISSA HERBRANSON PROVIDER 40.00 X 344999 0 58201 3822379 0 513208 86 0 1 0 CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN ST CROSBY MN 56441 MEDICAL/SURGICAL PROF SVCS 6091850 CENTRAL MINNESOTA DIAGNOSTICS INC 150 10TH ST MILACA MN 56353 RADIOLOGY PROF SVCS 1769491 LIFE GUARD ANESTHESIA SERVICES INC 29561 395TH PLACE AITKIN MN 56431 ANESTHESIA PROF SVCS 1727146 MEDICAL SOLUTIONS LLC 1010 N 102ND ST 300 OMAHA NE 68114 HOURLY LABOR 1625572 PREMIER SURGICAL ASSOCIATES PA 318 E MAIN ST CROSBY MN 56441 MEDICAL PROF SVCS 1127842 17 509968 57000 116153 683121 NET PATIENT SERVICE REVENUE 621500 101308490 101308490 RETAIL PHARMACY 456110 663011 663011 101971501 1118660 1118660 19589366 267053 20309090 0 -719724 267053 -452671 -452671 OTHER REVENUE 900099 857316 857316 EQUITY IN EARNINGS OF AFFILIATES 900099 523848 523848 CAFETERIA 900099 308628 308628 -383966 -383966 1305826 104626437 102305688 663011 974617 X 180572 180572 3500 3500 2294912 476331 1818581 35363867 31340162 4023705 1319976 1199131 120845 6553314 5843703 709611 2495761 2189046 306715 71040 71040 337308 337308 3798 3798 18502083 16390295 2111788 12426 12426 2535609 2139665 395944 2839 2839 1099832 944382 155450 106868 98470 8398 77390 54566 22824 1195641 957708 237933 4602897 3686920 915977 452139 452139 DRUGS 14226078 14226078 MEDICAL SUPPLIES 9997841 9818648 179193 REPAIRS & MAINTENANCE 1936364 1860668 75696 LICENSES & DUES 694022 159142 534880 2807158 274908 2532250 106873235 91846734 15026501 0 3748573 9283190 15928909 18891363 4586049 4782618 649101 760503 156008847 61564464 60213529 94444383 21460425 6732748 545591 424348 26069580 36956972 133201757 172276125 18133078 13929779 22329478 55739090 9628215 22148022 5364549 4507891 55455320 96324782 X 71115583 69461080 6630854 6490263 77746437 75951343 133201757 172276125 X -2246798 3075155 -167296 -2456155 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3798 3798 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. 572223 600 117235 8000 45788 636270 536857 50366 15000 572223 656179 8000 -111322 16000 536857 593667 77512 15000 656179 542002 250 51415 593667 0.20276 0.42393 0.37331 0 1 1 1684923 1684923 88993099 27626113 61366986 1143461 1143461 49879920 30010891 19869029 14307444 3927460 10379984 94444383 INVESTMENT IN RIVERWOOD MEDICAL PROPERTIES, LLC -1784279 ASSETS LIMITED FOR RESERVE ACCOUNTS 17582386 BENEFICIAL INTEREST IN NET ASSETS-H 6490262 ASSETS LIMITED BY BOARD FOR FUNDED 4246791 ASSETS LIMITED BY AGREEMENT FOR DEF 3546255 INVESTMENTS IN CENTRAL MINNESOTA DI 1602119 ASSETS LIMITED BY AGREEMENT FOR WOR 270259 LEASE RIGHT-OF-USE ASSET 4084139 THIRD PARTY PAYOR SETTLEMENTS 919040 36956972 OPERATING LEASE LIABILITY 4080388 INTEREST RATE SWAP 427503 4507891 X 105595599 3075155 -2072179 1002976 104592623 33814 33814 104626437 107442086 167296 435369 602665 106839421 33814 33814 106873235 PART V, LINE 4: TO BE USED AND DISTRIBUTED AS A SCHOLARSHIP OR EDUCATIONAL FUND TO AID IN THE EDUCATION AND RECRUITMENT OF HEALTH CARE PROFESSIONALS FOR RIVERWOOD HEALTHCARE CENTER. PART X, LINE 2: NONPROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED AND IN CERTAIN OTHER INSTANCES. NONPROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE ORGANIZATION HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: DECREASE IN INTEREST IN NET ASSETS - RIVERWOOD FOUNDATION -140,591. RIVERWOOD MEDICAL PROPERTIES, LLC REVENUE 126,000. ELIMINATIONS RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC 257,976. UNREALIZED GAIN/LOSS ON INTEREST RATE SWAPS -2,315,564. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE NETTED WITH REVENUE 33,814. PART XII, LINE 2D - OTHER ADJUSTMENTS: RIVERWOOD MEDICAL PROPERTIES, LLC EXPENSES 561,369. ELIMINATION RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -126,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE NETTED WITH REVENUE 33,814. 1 1 X 1 X 1 X 1 1 0 1 1 1331163 1331163 0.01250 11608668 10320971 1287697 0.01200 12939831 10320971 2618860 0.02450 1156821 1156821 0.01080 8940 8940 0.00010 1165761 1165761 0.01090 14105592 10320971 3784621 0.03540 1 0 27520333 28138423 -618090 X 1 1 1 1 RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN MN 56431 HTTPS://RIVERWOODHEALTHCARE.ORG/ 410477 X X X X N/A AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, PAGE 8 X 1 21 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, 51 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 ON THE COURSE AND FOLLOW OUR STRATEGIC PLAN. WE WILL CREATE THE FUTURE WE SEEK BY FOCUSING ON SIX STRATEGIC GOALS.1) COMMUNITY: EXPAND OUR COMMUNITY IMPACT TO INCREASE EMPHASIS ON HEALTH BEHAVIORS, SOCIAL/ECONOMIC FACTORS, AND ENHANCED COMMUNITY PARTNERSHIPS2) PEOPLE: FOSTER A HIGH PERFORMING WORKPLACE3) STEWARDSHIP: ACHIEVE SUSTAINABLE OPERATING MARGIN AND MAINTAIN ADVANTAGEOUS FINANCIAL AND CASH POSITION 4) QUALITY: EVOLVE OUR CLINICAL CARE DELIVERY MODEL AND CULTURE TO ACHIEVE TOP QUALITY KEY AMBULATORY AND INPATIENT MEASURE RESULTS AND HAVE ZERO PREVENTABLE SERIOUS SAFETY EVENTS5) GROWTH: EXPAND AND ENHANCE BOTH OUR PARTNERSHIP AND PATIENT RELATIONSHIPS6) CUSTOMER SERVICE: ACHIEVE PATIENT EXPERIENCE GOALS AND CREATE A CULTURE OF CUSTOMER SERVICE ACROSS ALL SERVICE LINESPRIORITY HEALTH ISSUES RIVERWOOD WILL ADDRESS:IN CONSIDERATION OF THE TOP HEALTH PRIORITIES IDENTIFIED THROUGH 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 3) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT3) HEART DISEASE & STROKEISSUES THAT RIVERWOOD WILL NOT ADDRESS INCLUDE ACCESS TO HEALTHCARE SERVICES FOR MENTAL HEALTH, DISABILITY & CHRONIC PAIN, INJURY & VIOLENCE, CANCER, ORAL HEALTH, SUBSTANCE ABUSE, AND COVID-19/ RESPIRATORY DISEASE. LIMITED RESOURCES EXCLUDED CANCER, ORAL HEALTH, SUBSTANCE ABUSE, DISABILITY AND CHRONIC PAIN AND RESPIRATORY DISEASE AS AREAS CHOSEN FOR ACTION AT THIS TIME. RIVERWOOD FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE HEALTHCARE 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 ETS A FOLDER OF BROCHURES OF HEALTHCARE INFORMATION AS PART OF THEIR STAY. THIS FOLDER CONTAINS INFORMATION REGARDING THE FAP AND LISTS THE FINANCIAL COUNSELORS CONTACT INFORMATION, SHOULD A PATIENT WANT TO MAKE CONTACT AFTER DISCHARGE FROM THE FACILITY. PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2023/03/2022-PRC-CHNA-REPORT-AITKIN-COUNTY-MN.PDF PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2023/03/2022-IMPLEMENTATION-STRATEGY-FINAL.PDF PART V, LINE 16A, FAP WEBSITE HTTPS://RIVERWOODHEALTHCARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/ PART V, LINE 16B, FAP APPLICATION WEBSITE HTTPS://VIEW.OFFICEAPPS.LIVE.COM/OP/VIEW.ASPX?SRC=HTTPS%3A%2F%2FRIVERWOODHEALTHCARE.ORG%2FWP-CONTENT%2FUPLOADS%2F2023%2F05%2F4-POLICY-4-COMMUNITY-CARE-AND-UNINSURED-PROGRAM-3.DOCX&WDORIGIN=BROWSELINK 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 2024 MEDICARE COST REPORT. PART I, LN 7 COL(F): IMPLICIT PRICE CONCESSIONS FROM FINANCIAL STATEMENTS IS $0. 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 HEATLHCARE CENTER (RIVERWOOD), A 501(C)3 NON-PROFIT CORPORATION, IS SITUATED IN THE CENTER OF AITKIN COUNTY. IT WAS FOUNDED IN 1948 AND IS LOCATED AT 200 BUNKER HILL DRIVE IN AITKIN, MN (POP. 1984). RIVERWOOD IS A 25 BED ACUTE-CARE CRITICAL ACCESS HOSPITAL AND HAS THREE RURAL HEALTH CLINICS IN AITKIN, MCGREGOR, AND GARRISON. ALL THREE CLINICS ARE LOCATED IN A MEDICALLY UNDERSERVED AREA (MUA). RIVERWOOD OFFERS PATIENTS A CONTINUUM OF CARE INCLUDING INPATIENT, OUTPATIENT, SPECIALTY, SURGICAL AND EMERGENCY SERVICES. THE DISTANCE TO THE NEXT HOSPITAL IS 17 MILES. DULUTH AND ST. CLOUD ARE THE TWO CLOSEST CITIES WITH TERTIARY CARE CENTERS BOTH APPROXIMATELY 90 MILES FROM AITKIN. RIVERWOOD SERVES THE RESIDENTS OF AITKIN COUNTY (POP. 15,834), THE EAST SIDE OF CROW WING COUNTY (POP. 63,855) AND MILLE LACS COUNTY (POP. 25,728). THE GEOGRAPHIC AREA OF THESE COUNTIES IS RURAL. SPECIAL POPULATIONS SERVED INCLUDE THOSE WITH A HIGH RATE OF POVERTY AND UNEMPLOYMENT WITHIN AITKIN 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 CONSIDS 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 ENFORCMENT, AREA SCHOOL DISTRICTS AND OTHER HEALTH CARE PROVIDERS TO EDUCATE, PLAN AND COLLABORATE ON HEALTHCARE NEEDS OF THE COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:N/A PART VI, LINE 7, REPORTS FILED WITH STATES MN 0 RIVERWOOD HEALTHCARE CENTER & COMMUNITY HOSPITAL FOUNDATION 200 BUNKER HILL AITKIN MN 56431 411738787 501(C)(3) 0 131158 FMV ADMINISTRATIVE EXPENSES TO PROVIDE ADMINISTRATIVE SUPPORT 1 0 DOLLARS FOR SCHOLARS HEALTHCARE EDUCATION SCHOLARSHIP 2 3000 RIVERWOOD EMPLOYEE HIGH SCHOOL SENIOR STUDENT SCHOLARSHIP 2 500 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 613257 0 0 0 45 0 13200 0 36807 0 663309 0 0 0 KEN WESTMAN CEO 431444 0 0 0 45 0 13200 0 39660 0 484349 0 0 0 DR JEFFREY EHNSTROM DIRECTOR/PHYSICIAN 424860 0 0 0 45 0 13200 0 42968 0 481073 0 0 0 DR JIM HARRIS ER PHYSICAN 420433 0 0 0 45 0 13200 0 36445 0 470123 0 0 0 DR JESSICA HODSON ER PHYSICAN 402689 0 0 0 45 0 13200 0 45968 0 461902 0 0 0 ROBERT SCHMIEG CRNA 380956 0 0 0 45 0 8580 0 35534 0 425115 0 0 0 DR CHRISTOPHER HUGHES PROVIDER 355709 0 1667 0 45 0 13200 0 38455 0 409076 0 0 0 DR MELISSA HERBRANSON PROVIDER 334954 0 10000 0 45 0 13200 0 45001 0 403200 0 0 0 CYNTHIA BAKER COO 229212 0 0 0 45 0 9538 0 37254 0 276049 0 0 0 CASEY JOHNSON CFO 216748 0 0 0 45 0 9046 0 35552 0 261391 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 2587788 5985025 89142 5895883 2013 1 0 1 1 B 3459017 8000000 119153 7880847 2013 1 0 1 1 C 3459017 8000000 119153 7880847 2013 1 0 1 1 D 2838072 9732000 194640 9537360 2019 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 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 30788 9000000 248443 8751557 2024 0 0 0 1 B 34209 10000000 277430 9722570 2024 0 0 0 1 C 34209 10000000 276600 9723400 2024 0 0 0 1 D 29077 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 JENNIFER EHNSTROM FAMILY MEMBER OF BOARD MEMBER JEFFREY EHNSTROM 20151 EMPLOYMENT 0 FORM 990, PART III, LINE 4A RIVERWOOD REPRESENTATIVES ACCEPTED THE AWARD FOR EXEMPLARY ACHIEVEMENT IN COMMUNITY BENEFITS FOR ADDRESSING SOCIAL DETERMINANTS OF HEALTH WITH PATIENTS. MHA SHARED THESE COMMENTS ON THE COMMUNITY BENEFITS AWARD: "THE TEAM AT RIVERWOOD RECOGNIZES THE UNIQUE NEEDS OF THE POPULATION THEY SERVE. WITH AN OLDER POPULATION IN A RURAL AREA, GETTING RESOURCES OUT TO THOSE WHO NEED THEM WAS A CHALLENGE THAT RIVERWOOD TOOK ON AND DEVELOPED COMMUNITY PARTNERSHIPS TO ADDRESS." 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. IN 2023, RIVERWOOD CONNECTS WENT LIVE WITH 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 TO CONNECT TO THEM DIRECTLY AND ELECTRONICALLY. WITH FINANCIAL AND ADMINISTRATIVE ASSISTANCE FROM AITKIN COUNTY CARE, RIVERWOOD IMPLEMENTED FIND HELP IN ITS FACILITY AND COMMUNITY WIDE. 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 PATIENT'S 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 LIKE BUDGET AND TRANSPORTATION TO ACCESSING FOOD. IN PARTNERSHIP WITH LOCAL FARMERS, AITKIN FARMERS MARKET HUB, AND AITKIN COUNTY STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP, PARTICIPANTS ARE PROVIDED COMMUNITY SUPPORTED AGRICULTURE SHARES AND "RIVERWOOD CONNECTS BUCKS" TO BE USED 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 NEW GRANT FROM MDA TO FUND PROJECTS THAT BUY LOCAL FOOD, PRIMARILY FROM SOCIALLY DISADVANTAGED AND EMERGING FARMERS, AND TO DISTRIBUTE FOOD TO UNDERSERVED COMMUNITIES. RIVERWOOD IS PARTNERING WITH THE AITKIN FARMERS MARKET HUB TO PURCHASE LOCALLY GROWN FOOD FROM AITKIN COUNTY'S VERY OWN AND NEARBY FARMERS. ADDITIONALLY, RIVERWOOD HAS PARTNERED WITH AITKIN COUNTY CARE AND ANGELS OF MCGREGOR TO HELP DISTRIBUTE THE FOOD BOXES TO THE SENIOR POPULATION THEY SERVE. THE GRANT, WHICH OFFERS MONEY FOR FOOD BOXES, ADMINISTRATION AND OUTREACH COSTS AND TRANSPORTATION, ALLOWS RIVERWOOD TO PROCURE FOOD FROM LOCAL FARMERS AND DISTRIBUTE FOOD BOXES THROUGH THE AITKIN FARMERS MARKET HUB. THE FIRST BOXES DISTRIBUTED IN JANUARY CONTAINED APPLES, HONEY, WHOLE WHEAT FLOUR, CORNMEAL, WILD RICE, DRY BEANS, OATMEAL, PORK CHOPS AND GROUND PORK. TOGETHER, BOXES WILL BE DELIVERED EACH MONTH FROM JANUARY TO MAY IN 2024 AND 2025. 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 IS PROVIDING THE 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, MN. PALISADE HAS BEEN IDENTIFIED AS A FOOD DESERT WITH LIMITED ACCESS TO LOCAL FOODS. RIVERWOOD, AITKIN COUNTY PUBLIC HEALTH'S STATE HEALTH IMPROVEMENT PROGRAM (SHIP), AITKIN FARMERS MARKET HUB, CARE, AND ANGELS MEET MONTHLY TO DISCUSS THE AREA OF HIGHEST NEED AND THE NEXT LOCATION TO TARGET WITH FOOD BOXES FOR SENIORS. THE NEW 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. THE INTENT IS TO ASSIST LOCAL FARMERS WITH PROCURING THEIR FOOD DURING THE HARDEST TIMES OF THE WINTER MONTHS AND TO ASSIST FOOD-INSECURE COMMUNITY MEMBERS. THE MINNESOTA DEPARTMENT OF HEALTH (MDH) AWARDED RIVERWOOD HEALTHCARE CENTER WITH THE 2023 MINNESOTA RURAL HEALTH TEAM AWARD FOR ITS WORK IN IDENTIFYING THE SOCIAL DETERMINANTS OF HEALTH AMONG ITS PATIENTS AND CREATING COMMUNITY PARTNERSHIPS TO ADDRESS THOSE NEEDS. RIVERWOOD WAS ONE OF FOUR MINNESOTA HEALTH ORGANIZATIONS AND INDIVIDUALS RECOGNIZED BY THE MDH OFFICE OF RURAL HEALTH AND PRIMARY CARE FOR THE 2023 MINNESOTA RURAL HEALTH AWARDS, WHICH WERE ANNOUNCED TO COINCIDE WITH NATIONAL RURAL HEALTH DAY ON NOV. 16. RIVERWOOD WORKS HARD TO PROVIDE SERVICES TO A DIVERSE POPULATION OF ELDERLY, LOW-INCOME, AND MULTI-GENERATIONAL FAMILIES. IN RESPONSE TO OUR 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, WE DEVELOPED THE RIVERWOOD CONNECTS PROGRAM (#TOGETHERWEWILLCONNECT) TO IDENTIFY THE UNIQUE NEEDS OF THE POPULATION WE SERVE AND TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. THIS COMMUNITY HEALTH INITIATIVE IS A COLLABORATIVE EFFORT WITH LEADERS FROM AITKIN COUNTY STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP (SHIP), AITKIN FARMERS MARKET HUB, AND AITKIN COUNTY CARE (COORDINATING AREA RESOURCES EFFECTIVELY). THEY HAVE BEEN WORKING TOGETHER TO IMPLEMENT FIND HELP, A 24/7 ON-LINE RESOURCE HUB, AS WELL AS ESTABLISH THE FOOD RX PROGRAM THAT PROVIDES QUALIFYING PARTICIPANTS WITH COMMUNITY SUPPORT AGRICULTURE (CSA) SHARES AND RIVERWOOD CONNECT BUCKS TO BE USED AT THE AITKIN FARMERS MARKET. ACCESS TO AFFORDABLE NUTRITIOUS FOOD AS WELL AS TO OTHER COMMUNITY RESOURCES SUCH AS TRANSPORTATION, UTILITY AND HOUSING ASSISTANCE, ARE ESSENTIAL RESOURCES THAT HELP ADVANCE HEALTH EQUITY IN AITKIN COUNTY AND BEYOND. RIVERWOOD DID A 2023 SURVEY WITH THE COMMUNITY RESOURCE QUESTIONNAIRE IN WHICH THE ORGANIZATION STARTED EVALUATING AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH WITH PATIENTS THROUGH THE RIVERWOOD CONNECTS PROGRAM. RIVERWOOD ASSESSED 1,352 UNIQUE PATIENTS AND DETERMINED THE TOP AREA OF NEED TO BE ACCESS AND SUPPORT FOR FOOD AT 38%; AFFORDABLE AND STABLE HOUSING AT 20%; TRANSPORTATION TO AND FROM WORK, APPOINTMENTS, NECESSITIES AT 7%; AND HOUSING AND UTILITIES MONEY AT 7%. RIVERWOOD REFERRED SEVENTY-SEVEN PATIENTS AND ENROLLED FIFTY-NINE PATIENTS INTO ITS FOOD RX PROGRAM. RIVERWOOD CONNECTS NOT ONLY HELPS COMMUNITY MEMBERS IN NEED BUT ALSO BY SUPPORTING LOCAL SMALL BUSINESSES AND ORGANIZATIONS THROUGHOUT THE COUNTY AND REGION. IN 2024, RIVERWOOD JOINED THE HEADWATERS HIGH-VALUE NETWORK WHICH ANNOUNCED ITS LAUNCH AS A COLLABORATION OF NINETEEN INDEPENDENT RURAL MINNESOTA HOSPITALS 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 NINETEEN HOSPITALS AND MORE THAN FIFTY 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 AN INNOVATIVE MODEL 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 THE 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 TO 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. FORM 990, PART III, LINE 4A HEADWATERS LEADERSHIP ANNOUNCED 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 A MENU OF SHARED SERVICES THAT PROMOTE MORE EFFICIENT OPERATIONS. THE NETWORK IS EXPLORING SHARED SOLUTIONS IN POPULATION HEALTH PLATFORM, 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." RIVERWOOD HEALTHCARE CENTER'S LAUNCHED AND INTRODUCED ITS NEW PODCAST, RIVERWOOD ON CALL. HOSTED BY OUR CHIEF MEDICAL OFFICER, DR. DAVID TAYLOR, THIS PODCAST WILL FEATURE INSIGHTFUL DISCUSSIONS AND INTERVIEWS WITH OUR PROVIDERS. OUR FIRST FOUR EPISODES FEATURE DR. TIMOTHY ARNOLD, A FAMILY PHYSICIAN AT THE MCGREGOR CLINIC. DR. ARNOLD SHARES HIS JOURNEY INTO MEDICINE AND HIS KEYS TO LIVING A HEALTHY LIFE. IN HIS CONVERSATION WITH DR. TAYLOR, HE DELVES INTO HIS PASSION FOR PRIMARY CARE AND THE CONCEPT OF HEALTH SPANHOW LONG WE LIVE HEALTHILY, RATHER THAN JUST LIVING LONGER. DR. ARNOLD EXPLAINS THAT WELLNESS IS NOT MERELY THE ABSENCE OF DISEASE BUT A BALANCE WITHIN THE BODY'S SYSTEMS. HE EMPHASIZES THAT HEALTH SHOULD BE VIEWED IN TERMS OF OVERALL WELL-BEING, CONSIDERING FACTORS LIKE MENTAL, PHYSICAL, AND SOCIAL HEALTH. THIS HOLISTIC APPROACH REFLECTS A SHIFT IN MEDICAL THINKING, MOVING BEYOND TRADITIONAL METRICS TO FOCUS ON QUALITY OF LIFE. LISTENERS GAIN VALUABLE INSIGHTS INTO VARIOUS HEALTH TOPICS, FROM PREVENTIVE CARE AND WELLNESS STRATEGIES TO INNOVATIVE TREATMENTS AND PERSONAL STORIES FROM OUR HEALTHCARE PROVIDERS. LISTEN TO EPISODES OF RIVERWOOD ON CALL ON SPOTIFY, PANDORA, APPLE PODCASTS, IHEART, OR ON THE RIVERWOOD WEBSITE. RIVERWOOD RECEIVED MORE FIVE STAR RATINGS FROM THE CENTERS FOR MEDICAID AND MEDICARE FOR EARNING A FIVE-STAR RATING FOR CLEANLINESS. THIS REPORT IS PRODUCED BASED ON PATIENT SATISFACTION SURVEYS ISSUED AND COMPILED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS). THIS IS A NATIONAL, STANDARDIZED SURVEY OF HOSPITAL PATIENTS ABOUT THEIR EXPERIENCE DURING A RECENT INPATIENT STAY. THE SURVEYS WERE COMPLETED BETWEEN OCTOBER 2022 AND SEPTEMBER 2023. "AT RIVERWOOD HEALTHCARE CENTER, OUR HOUSEKEEPING STAFF IS DEDICATED TO MAINTAINING A SPOTLESS HOSPITAL ENVIRONMENT THAT SUPPORTS THE HEALTH AND SAFETY OF OUR HOSPITAL PATIENTS," EXPLAINS APRIL BAXLEY, ENVIRONMENTAL SERVICES MANAGER. "OUR STAFF USES A ROBUST CHECKLIST TO ENSURE THEY DO NOT MISS ANY KEY AREAS OR HIGH-TOUCH POINTS OF CONTACT, SUCH AS DOOR HANDLES, ELEVATOR BUTTONS AND LIGHT SWITCHES, DURING THEIR REGULAR CLEANING ROUNDS. THIS NATIONAL HOSPITAL CLEANLINESS RATING IS A TESTAMENT TO THE OUTSTANDING WORK OF OUR ENTIRE ENVIRONMENTAL SERVICES TEAM." THE SURVEY IS GIVEN TO A RANDOM SAMPLE OF ADULT PATIENTS BETWEEN 2 AND 42 DAYS AFTER DISCHARGE AND INCLUDES TWENTY-SEVEN 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 5-STAR RATING SCALE, WITH 4- AND 5-STAR RATINGS BEING THE BEST. RIVERWOOD HEALTHCARE CENTER OFFERS FREE MONTHLY MEETUPS ON WOMEN'S HEALTH AND WELLNESS TOPICS AT LOCAL RESTAURANTS. PARTICIPANTS HEAR FROM LOCAL DOCTORS REGARDING WOMEN'S HEALTH ISSUES AND CONCERNS AND CAN ALSO ENJOY A MEAL PREPARED WITH LOCAL PRODUCE AND WITH SHARED RECIPES. THE GOAL IS TO PROVIDE A CASUAL FORUM FOR WOMEN TO GATHER AND GET BRIEF INFORMATION ABOUT HEALTH ISSUES AND HAVE FUN LEARNING HOW TO PURSUE HOBBIES OR OTHER INTERESTS. GATHERING TOGETHER HAS SOCIAL AND WELLNESS BENEFITS. PARTICIPANTS GET TIME TO RECHARGE, LEARN, AND FLOURISH TOGETHER. RIVERWOOD HEALTHCARE CENTER GOVERNING BOARD'S TWO NEW MEMBERS HAVE COMPLETED MINNESOTA HOSPITAL ASSOCIATION'S TRUSTEE CERTIFICATION PROGRAM. THEY WERE PART OF A GROUP OF HOSPITAL SYSTEM TRUSTEES FROM ACROSS MINNESOTA RECOGNIZED FOR THEIR SUCCESSFUL COMPLETION OF THE MINNESOTA HOSPITAL ASSOCIATION'S (MHA) RIGOROUS AND COMPREHENSIVE TRUSTEE CERTIFICATION PROGRAM. THIS CERTIFICATION UNDERSCORES THEIR UNWAVERING COMMITMENT TO THE PATIENTS, CARE TEAMS, AND COMMUNITIES THEY SERVE. MHA'S TRUSTEE CERTIFICATION PROGRAM PROVIDES HOSPITAL AND HEALTH SYSTEM TRUSTEES WITH TRAINING ON CURRENT HEALTH CARE TRENDS, GOVERNANCE BEST PRACTICES, ETHICS, GOVERNMENT REGULATIONS, AND PATIENT SAFETY AND QUALITY. PARTICIPANTS UNDERGO 30 HOURS OF COURSEWORK, MAKING MINNESOTA'S PROGRAM THE MOST COMPREHENSIVE IN THE NATION. THE MINNESOTA DEPARTMENT OF HEALTH RECERTIFIED RIVERWOOD HEALTHCARE CENTER AS A HEALTH CARE HOME. THIS MEANS THAT RIVERWOOD PRIMARY CARE CLINICS IN AITKIN, GARRISON AND MCGREGOR HAVE MET A SET OF RIGOROUS STANDARDS TO PROVIDE PATIENT AND FAMILY-CENTERED CARE AND WILL CONTINUE WORKING TO IMPROVE THE QUALITY, EXPERIENCE, AND VALUE OF CARE. HEALTH CARE HOMES PROVIDE COMPLETE CARE, RANGING FROM DISEASE PREVENTION TO MANAGEMENT OF COMPLEX AND CHRONIC CONDITIONS, AND ARE DEDICATED TO MEETING THE HIGHEST STANDARDS FOR HEALTH CARE DELIVERY. CERTIFIED HEALTH CARE HOME CLINICS OFFER A TEAM-BASED APPROACH TO PRIMARY CARE THAT MAKES IT EASIER FOR PATIENTS TO COMMUNICATE AND PARTNER WITH THEIR CARE TEAM. THEY ARE THEIR PATIENTS' HOME FOR HEALTH CARE. A HEALTH CARE HOME COORDINATES CARE WITH SPECIALISTS AND COMMUNITY SERVICES TO ENSURE PATIENTS RECEIVE WHAT THEY NEED TO STAY HEALTHY AND IMPROVE AND MANAGE THEIR HEALTH. THIS INCLUDES EXPANDED ACCESS TO APPOINTMENTS, 24/7 ACCESS TO A CLINIC REPRESENTATIVE, INITIATIVE-TAKING PLANNING FOR CARE, DESIGNATED PATIENT CARE COORDINATORS, AND AN OVERALL FOCUS ON QUALITY IMPROVEMENT. RIVERWOOD IS PROUD TO ANNOUNCE THAT ITS PRIMARY CARE CLINICS IN AITKIN, GARRISON AND MCGREGOR HAVE BEEN CERTIFIED BY THE MINNESOTA DEPARTMENT OF HEALTH AS LEVEL 3 HCHS. THIS MEANS THAT THE DESIGNATED CLINICS HAVE MET THE REQUIREMENTS OF THE FOUNDATIONAL LEVEL OF CERTIFICATION AS WELL AS THOSE OF LEVEL 2 AND HAVE FURTHER ADVANCED THEIR CARE MODEL. LEVEL 3 CLINICS HAVE DONE CONSIDERABLE WORK TO INTEGRATE CARE DELIVERY WITH THE COMMUNITY, INCLUDING CONTRIBUTING TO THE COMMUNITY HEALTH NEEDS ASSESSMENT AND POPULATION HEALTH IMPROVEMENT PROCESS, AS WELL AS PLAYING A ROLE IN IMPLEMENTING AND MONITORING THE PROGRESS OF COMMUNITY HEALTH IMPROVEMENT EFFORTS. AT RIVERWOOD, SEVEN REGISTERED NURSE CARE COORDINATORS WORK WITHIN THE HEALTH CARE TEAM TO PROVIDE CHRONIC CARE MANAGEMENT, PRINCIPAL CARE MANAGEMENT, AND BEHAVIORAL HEALTH INTEGRATION SERVICES TO OVER THREE HUNDRED PATIENTS WITH COMPLEX MEDICAL CONDITIONS OR NEEDS. THESE NURSES OFFER AN ADDED LAYER OF CARE, HELPING TO COORDINATE TREATMENT AND CONNECT PATIENTS WITH THE RESOURCES THEY NEED TO REACH THEIR HEALTH GOALS. CARE COORDINATION SERVICES HELP TO IMPROVE CARE TRANSITIONS THAT REDUCE HOSPITAL READMISSIONS, ADVERSE HEALTH EVENTS, AND UNNECESSARY EMERGENCY DEPARTMENT USE. DR. TIM ARNOLD, RIVERWOOD FAMILY PHYSICIAN, COMMENTS, "THE REGISTERED NURSE CARE COORDINATORS DO A GREAT JOB OF WATCHING THE HOSPITAL PATIENT LIST AND INCOMING MESSAGES AND MANAGING EMERGING PROBLEMS. THEY FOLLOW UP WITH PATIENTS REGULARLY, WHICH HELPS TO REDUCE CHRONIC DISEASE PROBLEMS AND NEW HEALTH ISSUES. THIS ALLOWS ME TO TAKE BETTER CARE OF MY PATIENTS." HEIDI OLESEN, RN, PRIMARY CARE SERVICES MANAGER, ADDS, "ACHIEVING A LEVEL 3 CERTIFICATION DEMONSTRATES THAT OUR CLINICS PROVIDE A HIGH LEVEL OF QUALITY CARE TO OUR PATIENTS. OUR TEAM WORKS TO COORDINATE CARE, ADDRESS SOCIAL DETERMINANTS OF HEALTH, FOCUS ON POPULATION AND COMMUNITY HEALTH, AND CONTINUOUSLY LOOKS FOR WAYS TO IMPROVE CARE DELIVERY AND OUTCOMES FOR OUR PATIENTS." AS AN ADDED MEASURE SHOWING STRONG COMMITMENT TO HEALTHCARE EXCELLENCE, RIVERWOOD WAS AGAIN RECOGNIZED BY BEING NAMED TO A LIST OF TOP 100 CRITICAL ACCESS HOSPITALS IN THE U.S., FOR THE SEVENTH TIME. THE CHARTIS CENTER FOR RURAL HEALTH COMPILES THESE RANKINGS THAT 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. FORM 990, PART III, LINE 4A WE CONTINUALLY EXAMINE EMERGING HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE THROUGHOUT AITKIN COUNTY AND THE GARRISON AND MILLE LACS AREA. WITH A STRONG FOCUS ON HEALTH, WELLNESS AND PREVENTION, THE CENTER STRIVES TO EDUCATE AND INFORM ITS PATIENTS AND THE COMMUNITY ON HEALTH ISSUES. THE COMMUNITY'S AND PATIENT'S NEEDS ARE LISTENED TO AND INCORPORATED IN OUR MISSION STATEMENT, STRATEGIC PLAN, AND VISION. TO ENSURE THAT WE CAN KEEP MEETING THE NEEDS OF THE PUBLIC UNDER OUR "PEOPLE" PILLAR, RIVERWOOD OPENED A NEW SURGICAL WING IN AUGUST 2024. WITH THE NEED FOR MORE OPERATING ROOMS AND LARGER ROOMS, THIS ALLOWED ACCOMMODATING THE TECHNOLOGY OF A DA VINCI ROBOT, VELYS ORTHOPEDIC EQUIPMENT AND UROSKOP INTERVENTIONAL UROLOGY OPERATING ROOM TABLE. THIS EXPANSION ALLOWED US TO MEET OUR LARGER SURGERY VOLUMES, OFFERING PRIVACY NEEDS FOR PATIENTS WHO DESERVE HEALING AND RECOVERY. THE HOSPITAL'S NEW SURGERY SPACE CONSISTS OF APPROXIMATELY 60,500 SQUARE FEET OF NEW SURGICAL DEPARTMENTS, INCLUDING SIX OPERATING ROOMS, TWO LARGE PROCEDURE ROOMS, THREE ENDOSCOPY ROOMS, TWENTY-FIVE PREP AND RECOVERY ROOMS, POST-ANESTHESIA CARE UNIT, STERILE PROCESSING, AND STAFF SUPPORT. THE ADDITION INCLUDES APPROXIMATELY 12,000 SQUARE FEET OF CLINICAL SPACE FOR GENERAL SURGERY, UROLOGY, AND OB/GYN. IN JANUARY 2024, AN ELECTRONIC HEALTH RECORD TRANSITION WENT LIVE, CREATING A DIGITAL FRONT DOOR EXPERIENCE THAT GAVE OUR PATIENTS MORE OWNERSHIP OVER THEIR CARE WHILE ADDING CONVENIENCE AND TIME-SAVING FEATURES. INTERNALLY, THIS CONVERSION GAVE RIVERWOOD MORE AUTONOMY AND FLEXIBILITY TO ADJUST AND STREAMLINE WORKFLOWS AND PROCESSES OF CARE, ALL DESIGNED FOR PERSONALIZATION OF THE SYSTEM TO BEST FIT PATIENTS' NEEDS. FORM 990, PART VI, SECTION A, LINE 6 RIVERWOOD HEALTHCARE CENTER HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A RIVERWOOD HEALTHCARE CENTER HAS MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD HAS AUTHORIZED THE FINANCE COMMITTEE TO REVIEW AND APPROVE THE 990 AFTER PREPARATION. AFTER APPROVAL BY THE FINANCE COMMITTEE, THE 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. CONFLICTS ARE DISCUSSED, REVIEWED, AND FORMS ARE SIGNED ANNUALLY BY EACH BOARD MEMBER. THIS IS DONE AT THE HOSPITAL'S ANNUAL REORGANIZATIONAL MEETING. SECTION 1. PURPOSE THE PURPOSE OF THIS POLICY IS TO PROVIDE A MEANS BY WHICH TO ADDRESS ANY CONFLICT OF INTEREST INVOLVING THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, AND EMPLOYEES THAT AFFECT OR HAVE THE POTENTIAL TO AFFECT THE SAFETY OR QUALITY OF CARE, TREATMENT, AND SERVICES. SECTION 2. PERSONS CONCERNED THIS STATEMENT IS DIRECTED NOT ONLY TO BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT, OR EMPLOYED PRACTITIONERS, BUT TO ALL EMPLOYEES OR NON-EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF RHCC. FOR EXAMPLE, THIS WOULD INCLUDE ALL WHO MAKE PURCHASING DECISIONS, ALL PERSONS WHO MIGHT BE DESCRIBED AS "MANAGEMENT PERSONNEL, AND ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING RHCC. SECTION 3. AREAS IN WHICH CONFLICT MAY ARISE CONFLICTS OF INTEREST MAY ARISE IN THE RELATIONS OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WITH ANY OF THE FOLLOWING THIRD PARTIES: 1. PERSONS AND FIRMS SUPPLYING GOODS AND SERVICES TO RHCC. 2. PERSONS AND FIRMS FROM WHOM RHCC LEASES PROPERTY AND EQUIPMENT. 3. PERSONS AND FIRMS WITH WHOM RHCC IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES, OR OTHER PROPERTY. 4. COMPETING OR AFFINITY ORGANIZATIONS. 5. DONORS AND OTHERS SUPPORTING RHCC. 6. AGENCIES, ORGANIZATIONS AND ASSOCIATIONS WHICH AFFECT THE OPERATIONS OF RHCC. 7. FAMILY MEMBERS, FRIENDS, AND OTHER EMPLOYEES. SECTION 4. NATURE OF CONFLICTING INTEREST A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS MENTIONED IN SECTION 3. SUCH AN INTEREST MIGHT ARISE THROUGH: SECTION 5. INTERPRETATION OF THIS STATEMENT OF POLICY THE AREAS OF CONFLICTING INTEREST LISTED IN SECTION 3, AND THE RELATIONS IN THOSE AREAS WHICH MAY GIVE RISE TO CONFLICT, AS LISTED IN SECTION 4, ARE NOT EXHAUSTIVE. CONFLICTS MIGHT ARISE IN OTHER AREAS OR THROUGH OTHER RELATIONS. IT IS ASSUMED THAT THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES WILL RECOGNIZE SUCH AREAS AND RELATION BY ANALOGY. THE FACT THAT ONE OF THE INTERESTS DESCRIBED IN SECTION 4 EXISTS DOES NOT NECESSARILY MEAN THAT A CONFLICT EXISTS, OR THAT THE CONFLICT, IF IT EXISTS, IS MATERIAL ENOUGH TO BE OF PRACTICAL IMPORTANCE, OR IF MATERIAL, THAT UPON FULL DISCLOSURE OF ALL RELEVANT FACTS AND CIRCUMSTANCES IT IS NECESSARILY ADVERSE TO THE INTERESTS OF RHCC. HOWEVER, IT IS THE POLICY OF THE GOVERNING BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS DESCRIBED IN SECTION 4 SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARDS OF DIRECTORS, OFFICERS, LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. SECTION 6. DISCLOSURE POLICY AND PROCEDURE PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST AND ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE GOVERNING BOARD OF DIRECTORS OR TO A COMMITTEE WITH BOARD-DELEGATED POWERS; 2. THE PERSON WITH THE CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL BE EXCLUDED FROM THE DISCUSSION AND VOTE ON APPROVAL OF SUCH TRANSACTION; 3. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 4. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER RHCC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST; 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN RHCC'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO RHCC, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. DISCLOSURE DISCLOSURE IN RHCC SHOULD BE MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE GOVERNING BOARD OF DIRECTORS. DISCLOSURE INVOLVING DIRECTORS SHOULD BE MADE TO THE GOVERNING BOARD CHAIR (OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE GOVERNING BOARD VICE-CHAIR) WHO SHALL BRING THESE MATTERS TO THE GOVERNING BOARD. DECISION THE GOVERNING BOARD OF DIRECTORS OR A COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO RHCC. IN THE CASE OF A CONFLICT INVOLVING A MEMBER OF THE GOVERNING BOARD OF DIRECTORS, THE GOVERNING BOARD OR COMMITTEE REVIEWING THE MATTER SHALL CONSIDER THE DISABLING GUIDELINES ATTACHED HERETO. THE DECISION OF THE GOVERNING BOARD OR COMMITTEE ON THESE MATTERS WILL REST IN ITS SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF RHCC AND THE ADVANCEMENT OF RHCC'S PURPOSE. SECTION 7. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY 1. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. 2. IF, AFTER HEARING THE RESPONSE OF THE PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE NO ACTION, REPRIMAND, REQUEST FOR RESIGNATION OR REMOVAL FROM THE BOARD OF DIRECTORS AS THE FACTS AND CIRCUMSTANCES MAY WARRANT. SECTION 9. COMPENSATION 1. A VOTING MEMBER OF THE BOARD OF DIRECTORS WHO RECEIVES COMPENSATION FOR PROVISION OF SERVICES AS AN EMPLOYEE OR CONTRACTOR, DIRECTLY OR INDIRECTLY, FROM RHCC IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 2. A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 3. NO MEMBER OF THE BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM RHCC, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. 4. PHYSICIANS WHO RECEIVE COMPENSATION FROM RHCC, WHETHER DIRECTLY OR INDIRECTLY OR AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS. NO PHYSICIAN, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING PHYSICIAN COMPENSATION. SECTION 10. ANNUAL STATEMENTS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING OR FOUNDATION BOARD DELEGATED POWERS, AND ALL LICENSED INDEPENDENT, CONTRACT OR EMPLOYED PRACTITIONERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON-- 1. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2. HAS READ AND UNDERSTANDS THE POLICY; 3. HAS AGREED TO COMPLY WITH THE POLICY; AND 4. UNDERSTANDS THAT RHCC IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15A RIVERWOOD HAS A COMPENSATION COMMITTEE OF THE BOARD 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. 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 6,004,633. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,004,633. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 10,385,662. MANAGEMENT AND GENERAL EXPENSES 2,111,788. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,497,450. FORM 990, PART XI, LINE 9: DECREASE IN INTEREST IN NET ASSETS OF RIVERWOOD FOUNDATION -140,591. UNREALIZED GAIN ON INTEREST RATE SWAPS -2,315,564. RIVERWOOD HEALTH CARE CENTER FOUNDATION 200 BUNKER HILL DRIVE AITKIN MN 56431 411738787 SUPPORT MN 501(C)(3) LINE 12A, I RIVERWOOD HEALTHCARE CENTER 1 RIVERWOOD MEDICAL PROPERTIES LLC 200 BUNKER HILL DRIVE AITKIN MN 56431 823113322 SUPPORT MN 501(C)(3) LINE 12A, I RIVERWOOD HEALTHCARE CENTER 1 1 1 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 RIVERWOOD FOUNDATION C 509050 FMV RIVERWOOD FOUNDATION B 131158 FMV RIVERWOOD MEDICAL PROPERTIES K 126000 FMV RIVERWOOD MEDICAL PROPERTIES A 99 FMV