RIVERVIEW HEALTHCARE ASSOCIATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- RIVERVIEW HEALTHCARE ASSOCIATION (EIN 41-0724029)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-04
- IRS object ID
- 201412169349300111
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-04T09:13:16-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 W FIRST ST STE 700 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 558021919 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410724029 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERVIEW HEALTHCARE ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RIVE | NameControl |
| Phone | 2182819200 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 SOUTH MINNESOTA STREET | AddressLine1 |
| City | CROOKSTON | City |
| State | MN | State |
| ZIP Code | 56716 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CARRIE MICHALSKI | Name |
| Title | PRESIDENT-CEO | Title |
| Phone | 2182819200 | Phone |
| Date Signed | 2014-07-16 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY BETH SANTORI | Name |
| PTIN | P00023783 | PTIN |
| Phone | 2187275025 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CARRIE MICHALSKI | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 SOUTH MINNESOTA STREET | AddressLine1 |
| City | CROOKSTON | City |
| State | MN | State |
| ZIP Code | 56716 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 51009212 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | RIVERVIEWHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1898 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 605 | TotalNbrEmployees |
| Total Nbr Volunteers | 110 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 527014 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 265506 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 53488649 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 50457288 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 62976 | InvestmentIncomePriorYear |
| Investment Income Current Year | 99050 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 134266 | OtherRevenuePriorYear |
| Other Revenue Current Year | 142937 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 54212905 | TotalRevenuePriorYear |
| Total Revenue Current Year | 50964781 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30652076 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29824869 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 23789102 | OtherExpensePriorYear |
| Other Expenses Current Year | 24341128 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 54441178 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54165997 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -228273 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3201216 | RevenuesLessExpensesCY |
| Total Assets BOY | 42352362 | TotalAssetsBOY |
| Total Assets EOY | 38420464 | TotalAssetsEOY |
| Total Liabilities BOY | 24213883 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23486995 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18138479 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14933469 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 40407074 | Expense |
| Revenue | 45702066 | Revenue |
| Description | HOSPITAL AND CLINIC - 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. HOSPITAL ADMISSIONS 1,019, PATIENT DAYS 3,673, OUTPATIENT VISITS 37,417, SURGERY 2,381, AND ER PATIENTS 6,852. THE CLINICS PROVIDE A WIDE RANGE OF SERVICES INCLUDING FAMILY PRACTICE DOCTORS AND SPECIALTY DOCTORS. CLINIC PATIENT VISITS 31,107. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4377819 | Expense |
| Revenue | 2696907 | Revenue |
| Description | NH CARE CENTER, HOME HEALTH AND ASSISTED LIVING - RIVERVIEW CARE CENTER PROVIDES STIMULATING DAILY ACTIVITIES FOR ITS RESIDENTS IN AN ENJOYABLE ENVIRONMENT AND A CARING ATMOSPHERE WHERE ALL RESIDENTS ARE TREATED WITH THE UTMOST DIGNITY. THE MEMORY CARE UNIT PROMOTES A CALM & THERAPEUTIC ATMOSPHERE. RIVERVIEW CARE CENTER IS A 24-BED FACILITY. NURSING HOME ADMISSIONS 8 AND RESIDENT DAYS 8,040. RIVERVIEW HOME CARE IS A FULL SERVICE HOME CARE AGENCY PROVIDING 24 HR ACCESS TO ON CALL NURSES, ROUTINE SERVICE ON WEEKENDS AND HOLIDAYS AND A FULL RANGE OF THERAPY SERVICES. HOME HEALTH PATIENTS 1,372 AND PATIENT VISITS 6,722. 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. ASSISTED LIVING PATIENTS 294 AND PATIENT VISITS 4,466. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2913612 | Expense |
| Revenue | 2058315 | Revenue |
| Description | 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 CHEMICALS. THE RECOVERY CENTER OPERATES CLINICS IN CROOKSTON, EAST GRAND FORKS, THIEF RIVER FALLS & ROSEAU MINNESOTA. RECOVERY CENTER OUTPATIENT VISITS 4,820. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 47698505 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 227 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 605 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETTY ARVIDSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2182819756 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 SOUTH MINNESOTA ST | AddressLine1 |
| City | CROOKSTON | City |
| State | MN | State |
| ZIP Code | 56716 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JENNY AMON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ROBIN BREKKEN | |||||||
| VICE PRESIDENT | 2.00 | X | 0 | 0 | 0 | X | |
| DR COLIN FENNELL | |||||||
| DIRECTOR | 41.00 | X | 611754 | 0 | 34064 | ||
| TRENT FISCHER | |||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | |
| MATTHEW FORGIT | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL MOORE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANDREW SVEC | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |
| SUE WESTROM | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | |
| MICHELLE COTE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANDY OMAN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ROSS MATLACK | |||||||
| PRESIDENT & CEO | 40.00 | 241213 | 0 | 30667 | X | ||
| CARRIE MICHALSKI | |||||||
| PRESIDENT & CEO | 40.00 | 130046 | 0 | 23967 | X | ||
| BILL BENNETT | |||||||
| CFO | 40.00 | 143461 | 0 | 11933 | X | ||
| BETTY ARVIDSON | |||||||
| VP CFO | 40.00 | 86445 | 0 | 6284 | X | ||
| SANDY BOICE | |||||||
| VP CHIEF NURSING OFFICER | 40.00 | 118907 | 0 | 12022 | X | ||
| JEAN TATE | |||||||
| VP OF HUMAN RESOURCES | 40.00 | 105100 | 0 | 12869 | X | ||
| DR IDATONYA AFONYA | |||||||
| VP MEDICAL AFFAIRS | 40.00 | 334826 | 0 | 31880 | X | ||
| CHRIS BRUGGEMAN | |||||||
| VP COO | 40.00 | 78298 | 0 | 5443 | X | ||
| LANCE NORMAN | |||||||
| VP AUXILIARY SERVICES | 40.00 | 109896 | 0 | 8628 | X | ||
| DR OLATUBOSUN FASHORO | |||||||
| PHYSICIAN | 40.00 | 455614 | 0 | 32103 | X | ||
| DR MIRZA BAIG | |||||||
| PHYSICIAN | 40.00 | 314432 | 0 | 31840 | X | ||
| DR ERIK KANTEN | |||||||
| PHYSICIAN | 40.00 | 490839 | 0 | 31173 | X | ||
| DR STEVEN SCHULTZ | |||||||
| PHYSICIAN | 40.00 | 327706 | 0 | 29647 | X | ||
| DR KARI WESSMAN | |||||||
| PHYSICIAN | 40.00 | 333873 | 0 | 13335 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3882410 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 315855 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SEIMENS FINANCIAL | |||||
| PO BOX 2083 | CAROL STREAM | IL | 60132 | XRAY IMAGING | 1149241 |
| NEW HORIZON FOODS | |||||
| PO BOX 860246 | MINNEAPOLIS | MN | 55486 | FOOD | 1128972 |
| WAPITI MEDICAL GROUP | |||||
| PO BOX 523 | MILBANK | SD | 57252 | ER PHYSICIANS | 1095615 |
| UNIVERSAL HOSPITAL SERVICES | |||||
| SDS 12-0940 PO BOX 86 | MINNEAPOLIS | MN | 55486 | BIO-MEDICAL | 693878 |
| SHARED MEDICAL TECHNOLOGY | |||||
| 202 WEST NEWTON ST | RICE LAKE | WI | 54868 | XRAY IMAGING | 365934 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 13 | NumberOfContractorsGT100K |
| Federated Campaigns | 3125 | FederatedCampaigns |
| Related Organizations | 30074 | RelatedOrganizations |
| Government Grants | 8355 | GovernmentGrants |
| All Other Contributions | 223952 | AllOtherContributions |
| Total Contributions | 265506 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| RIVERVIEW HOSPITAL | 621990 | 37739022 | 37739022 |
| PHYSICIAN CLINICS | 621110 | 7068183 | 7068183 |
| GLENMORE RECOVERY CENTER | 624310 | 2058315 | 2058315 |
| RIVERVIEW CARE CENTER | 623000 | 1820240 | 1820240 |
| HOME HEALTH & ASSISTED | 621610 | 876667 | 876667 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 894861 | TotalRevenueColumn |
| Related Or Exempt Function Income | 894861 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 50457288 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60202 | TotalRevenueColumn |
| Exclusion | $60,202 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 83279 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 44431 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 38848 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38848 | TotalRevenueColumn |
| Exclusion | $38,848 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAFE SALE | Description |
| Business Code | 722210 | BusinessCode |
| Total Revenue Column | 142937 | TotalRevenueColumn |
| Exclusion | $142,937 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 142937 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50964781 | TotalRevenueColumn |
| Related Or Exempt Function Income | 50457288 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $241,987 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2045229 | Total |
| Program Services | 1017754 | ProgramServices |
| Management And General | 1027475 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22424480 | Total |
| Program Services | 20811309 | ProgramServices |
| Management And General | 1613171 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 972871 | Total |
| Program Services | 904285 | ProgramServices |
| Management And General | 68586 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2856059 | Total |
| Program Services | 2606908 | ProgramServices |
| Management And General | 249151 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1526230 | Total |
| Program Services | 1366676 | ProgramServices |
| Management And General | 159554 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59085 | Total |
| Program Services | 12400 | ProgramServices |
| Management And General | 46685 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141521 | Total |
| Program Services | 2625 | ProgramServices |
| Management And General | 138896 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1028492 | Total |
| Management And General | 1028492 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 575097 | Total |
| Management And General | 575097 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 875312 | Total |
| Program Services | 875312 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2266075 | Total |
| Program Services | 2266075 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261407 | Total |
| Management And General | 261407 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| NURSING SERVICE SUPPLIE | 8285890 | 8285890 |
| OTHER MEDICAL SUPPLIES | 5745836 | 5745836 |
| GENERAL SERVICES SUPPLI | 2022676 | 2022676 |
| PROVISION FOR DOUBTFUL | 1780759 | 1780759 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1298978 | Total |
| Management And General | 1298978 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54165997 | Total |
| Program Services | 47698505 | ProgramServices |
| Management And General | 6467492 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2139 | BOY |
| EOY | 1893 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1680811 | BOY |
| EOY | 3570544 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14493312 | BOY |
| EOY | 10544601 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 424833 | BOY |
| EOY | 277139 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1194662 | BOY |
| EOY | 1132324 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155307 | BOY |
| EOY | 130944 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 46611744 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 29874661 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18721984 | BOY |
| EOY | 16737083 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4280558 | BOY |
| EOY | 5052864 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1398756 | BOY |
| EOY | 973072 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42352362 | BOY |
| EOY | 38420464 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7741789 | BOY |
| EOY | 7192575 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 514461 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14365000 | BOY |
| EOY | 13940000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11318 | BOY |
| EOY | 5144 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1547576 | BOY |
| EOY | 1404165 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 548200 | BOY |
| EOY | 430650 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24213883 | BOY |
| EOY | 23486995 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18138479 | BOY |
| EOY | 14933469 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18138479 | BOY |
| EOY | 14933469 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42352362 | BOY |
| EOY | 38420464 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -3201216 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -3794 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $696 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 696 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | RIVERVIEW HEALTHCARE ASSOCIATION PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 881779 | BeginningOfYearBalance |
| Contributions | 982 | Contributions |
| Investment Earnings Or Losses | 31628 | InvestmentEarningsOrLosses |
| Other Expenditures | 788 | OtherExpenditures |
| End Of Year Balance | 913601 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 815153 | BeginningOfYearBalance |
| Contributions | 2205 | Contributions |
| Investment Earnings Or Losses | 65454 | InvestmentEarningsOrLosses |
| Other Expenditures | 1033 | OtherExpenditures |
| End Of Year Balance | 881779 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 815243 | BeginningOfYearBalance |
| Contributions | 3994 | Contributions |
| Investment Earnings Or Losses | -4039 | InvestmentEarningsOrLosses |
| Other Expenditures | 45 | OtherExpenditures |
| End Of Year Balance | 815153 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 778984 | BeginningOfYearBalance |
| Contributions | 816 | Contributions |
| Investment Earnings Or Losses | 38940 | InvestmentEarningsOrLosses |
| Other Expenditures | 3497 | OtherExpenditures |
| End Of Year Balance | 815243 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 770200 | BeginningOfYearBalance |
| Contributions | 3221 | Contributions |
| Investment Earnings Or Losses | 18491 | InvestmentEarningsOrLosses |
| Other Expenditures | 12928 | OtherExpenditures |
| End Of Year Balance | 778984 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 813932 | OtherCostOrOtherBasis |
| Book Value | 813932 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26014352 | OtherCostOrOtherBasis |
| Depreciation | 15815704 | Depreciation |
| Book Value | 10198648 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13325572 | OtherCostOrOtherBasis |
| Depreciation | 10492613 | Depreciation |
| Book Value | 2832959 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6457888 | OtherCostOrOtherBasis |
| Depreciation | 3566344 | Depreciation |
| Book Value | 2891544 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16737083 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | WORKERS COMPENSATION | Description |
| Amount | $430,650 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 430650 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 49404115 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -3794 | NetUnrealizedGainsInvestments |
| Other Revenues | -1556872 | OtherRevenues |
| Revenue Not Rptd F990 | -1560666 | RevenueNotRptdF990 |
| Revenue Subtotal | 50964781 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 50964781 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 52490597 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 105359 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 105359 | ExpensesNotRptdF990 |
| Expenses Subtotal | 52385238 | ExpensesSubtotal |
| Other Expenses Not Included | 1780759 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1780759 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 54165997 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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: | THE ASSOCIATION'S ENDOWMENT INCLUDES FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. THESE FUNDS ARE MAINTAINED IN THE FOUNDATION. THE FUNDS ARE USED TO PROVIDE TO THE RESIDENTS OF ITS 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 THE RIVERVIEW HEALTHCARE ASSOCIATION TO PURCHASE MEDICAL EQUIPMENT AND SUPPLIES FOR PROMOTION OF HEALTHCARE IN THE COMMUNITY. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| PART X, LINE 2: | NOT-FOR-PROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED, AND IN CERTAIN OTHER INSTANCES. NOT-FOR-PROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE ASSOCIATION HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE ASSOCIATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2010. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| RIVERVIEW FOUNDATION REVENUE 223,887. PROVISION FOR DOUBTFUL RECEIVABLES -1,780,759. | PART XI, LINE 2D - OTHER ADJUSTMENTS: | |
| RIVERVIEW FOUNDATION EXPENSES 105,359. | PART XII, LINE 2D - OTHER ADJUSTMENTS: | |
| PROVISION FOR DOUBTFUL RECEIVABLES 1,780,759. | PART XII, LINE 4B - OTHER ADJUSTMENTS: |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 230.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 536539 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 536539 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01020 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7738564 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7738564 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14770 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8275103 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8275103 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15790 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 89884 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 89884 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 321935 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 321935 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00610 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10485324 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7888718 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2596606 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04960 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 43800 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 43800 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10940943 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7888718 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3052225 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05820 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19216046 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7888718 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11327328 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.21610 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,780,759 | BadDebtExpenseAmount |
| Amount Attributable To | 118189 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11411910 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11419945 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8035 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERVIEW HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 SOUTH MINNESOTA ST | AddressLine1 |
| City | CROOKSTON | City |
| State | MN | State |
| ZIP Code | 56716 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERVIEW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 230.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 10 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (10 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| RIVERVIEW CLINICS CROOKSTON | ||||
| 323 SOUTH MINNESOTA ST | CROOKSTON | MN | 56716 | OUTPATIENT CLINIC |
| RIVERVIEW CLINIC EAST GRAND FORKS | ||||
| 1428 CENTRAL AVE NE | EAST GRAND FORKS | MN | 56721 | OUTPATIENT CLINIC/REHAB |
| RIVERVIEW CLINIC FERTILE | ||||
| 206 NORTH MILL ST | FERTILE | MN | 56540 | OUTPATIENT CLINIC |
| RIVERVIEW CLINIC RED LAKE FALLS | ||||
| PARK PLACE MALL | RED LAKE FALLS | MN | 56750 | OUTPATIENT CLINIC/REHAB |
| RIVERVIEW CARE CENTER | ||||
| 323 SOUTH MINNESOTA ST | CROOKSTON | ND | 56716 | NURSING HOME |
| RIVERVIEW HOME CARE | ||||
| 721 SOUTH MINNESOTA ST | CROOKSTON | MN | 56716 | HOME HEALTH |
| RIVERVIEW RECOVERY CROOKSTON | ||||
| 23616 US HWY 2 SW | CROOKSTON | MN | 56716 | CHEMICAL DEPENDENCY |
| RIVERVIEW RECOVERY THIEF RIVER FALLS | ||||
| 309 NORTH LEBREE AVE SUITE 10 | THIEF RIVER FALLS | MN | 56701 | CHEMICAL DEPENDENCY |
| RIVERVIEW RECOVERY ROSEAU | ||||
| 216 CENTER ST WEST 101 | ROSEAU | MN | 56751 | CHEMICAL DEPENDENCY |
| RIVERVIEW RECOVERY EAST GRAND FORKS | ||||
| 201 GATEWAY DRIVE NE SUITE 4 | EAST GRAND FORKS | MN | 56721 | CHEMICAL DEPENDENCY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED 2013 MEDICARE COST REPORT.(PART I, LINE 7E) 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 COMMUNITY 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 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) 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 ANETHESIOLOGY, RESPIRATORY THERAPY, PHYSICAL THERAPY, CARDIAC REHAB, OCCUPATIONAL THERAPY, IMPLANTABLE DEVICES CHARGED TO PATIENTS, CLINIC, EMERGENCY, AND OBSERVATION BEDS.(PART I, LINE 7I) FINANCIAL CONTRIBUTIONS INCLUDE MONIES FOR SPONSORSHIPS AND IN-KIND SERVICES DONATED TO INDIVIDUALS OR THE COMMUNITY. THIS INCLUDES OVERHEAD EXPENSES OF SPACE DONATED TO NONPROFIT COMMUNITY GROUPS FOR MEETINGS (AA, BONE BUILDERS, ROTARY CLUB), DONATIONS OF MEDICAL SUPPLIES AND LINEN AND MEDICAL CARE PROVIDED AT A COMMUNITY EVENT. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS 1,780,759. | ||
| PART II: N/A | ||
| PART III, LINE 4: FROM FOOTNOTE 1 OF THE AUDITED FINANCIAL STATEMENTS - "PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT RECEIVABLES ARE WRITTEN OFF WHENDEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED."WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES TO DETERMINE PERCENTAGE OF BAD DEBTS EXPENSE AT COST. DISCOUNT INFORMATION IS PROVIDED BY THE THIRD PAYOR (ACCORDING TO CONTRACTS) AND RECORDED FOLLOWING GAAP GUIDELINES. BAD DEBT EXPENSE IS DETERMINED ACCORDING TO OUR PAYMENT AND COLLECTION POLICY MANUAL BAD DEBT AMOUNTS ARE NOT INCLUDED IN COMMUNITY BENEFITS.ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE 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 MANAGEMENT LETTER. | ||
| PART III, LINE 8: THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND THUS IS REIMBURSED AT 101% OF COST. THE MEDICARE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $419,318 AND ALLOWABLE COSTS OF $1,661,496 RESULTING IN A SHORTFALL OF $1,242,178. THE SHORTFALL IS THE RESULT OF UNREIMBURSED PROFESSIONAL CARE.THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. | ||
| PART III, LINE 9B: 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 WORK 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 V, SECTION B, LINE 3: OUR LEAD PERSON (CHIEF OPERATING OFFICER) GATHERED INFORMATION ELECTRONICALLY FROM THE FOLLOWING PERSONS IN THE COMMUNITY: POLK COUNTY PUBLIC HEALTH, NORTHWEST MENTAL HEALTH, POLK COUNTY SOCIAL SERVICES, WELLNESS COALITION, RIVERVIEW BOARD OF DIRECTORS, RIVERVIEW ASSOCIATION MEMBERS, AND CROOKSTON PUBLIC SCHOOLS. | RIVERVIEW HOSPITAL | |
| PART V, SECTION B, LINE 5C: THE NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE AND IS AVAILABLE UPON REQUEST FROM THE HOSPITAL FACILITY. | RIVERVIEW HOSPITAL | |
| PART V, SECTION B, LINE 12H: FAMILY SIZE | RIVERVIEW HOSPITAL | |
| PART V, SECTION B, LINE 20D: EVERYONE IS CHARGED THE SAME GROSS AMOUNT, BUT THE DISCOUNT FOR UNDERINSURED IS DETERMINED BY USING THE LARGEST COMMERCIAL INSURANCE RATE. | RIVERVIEW HOSPITAL | |
| 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 FINANCIAL 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 35,700. THE UNEMPLOYMENT RATE IS BELOW THE STATE LEVEL. THE MAJORITY OF WORKERS ARE EMPLOYED IN HEALTHCARE, MANUFACTURING OR FARMING. DESPITE A HIGHER RATE OF EMPLOYMENT, NEARLY 25 PERCENT OF HOUSEHOLDS EARN LESS THAN $25,000.00 PER YEAR COMPARED TO 20 PERCENT OF HOUSEHOLDS STATEWIDE. | ||
| 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 6: N/A | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR COLIN FENNELL | ||||||||||||||
| DIRECTOR | 611754 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 20314 | 0 | 645818 | 0 | 0 | 0 |
| ROSS MATLACK | ||||||||||||||
| PRESIDENT & CEO | 241213 | 0 | 0 | 0 | 0 | 0 | 13583 | 0 | 17084 | 0 | 271880 | 0 | 0 | 0 |
| CARRIE MICHALSKI | ||||||||||||||
| PRESIDENT & CEO | 130046 | 0 | 0 | 0 | 0 | 0 | 7608 | 0 | 16359 | 0 | 154013 | 0 | 0 | 0 |
| BILL BENNETT | ||||||||||||||
| CFO | 143461 | 0 | 0 | 0 | 0 | 0 | 8057 | 0 | 3876 | 0 | 155394 | 0 | 0 | 0 |
| DR IDATONYA AFONYA | ||||||||||||||
| VP MEDICAL AFFAIRS | 334826 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 18130 | 0 | 366706 | 0 | 0 | 0 |
| DR OLATUBOSUN FASHORO | ||||||||||||||
| PHYSICIAN | 455614 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 18353 | 0 | 487717 | 0 | 0 | 0 |
| DR MIRZA BAIG | ||||||||||||||
| PHYSICIAN | 314432 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 18090 | 0 | 346272 | 0 | 0 | 0 |
| DR ERIK KANTEN | ||||||||||||||
| PHYSICIAN | 490839 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 17423 | 0 | 522012 | 0 | 0 | 0 |
| DR STEVEN SCHULTZ | ||||||||||||||
| PHYSICIAN | 327706 | 0 | 0 | 0 | 0 | 0 | 13750 | 0 | 15897 | 0 | 357353 | 0 | 0 | 0 |
| DR KARI WESSMAN | ||||||||||||||
| PHYSICIAN | 333873 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 13335 | 0 | 347208 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF CROOKSTON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416005076 | IssuerEIN |
| CUSIP Number | 227235AL2 | CUSIPNumber |
| Date Issued | 2007-05-22 | DateIssued |
| Issue Price | 15875000 | IssuePrice |
| Description Of Purpose | REFUNDING & CONSTRUCTION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 1935000 | AmountRetired |
| Total Proceeds | 15875000 | TotalProceeds |
| Amount In Reserve Fund | 1161441 | AmountInReserveFund |
| Issuance Costs From Proceeds | 317500 | IssuanceCostsFromProceeds |
| Capital Expenditures | 14376695 | CapitalExpenditures |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | RIVERVIEW HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7A | RIVERVIEW HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND THE ACCOUNTING MANAGER FOR ACCURACY AND COMPLETENESS PRIOR TO FILING. ALL QUESTIONS AND CHANGES ARE ADDRESSED AS NECESSARY. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST 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 INTEREST FROM ARISING. 1. EMPLOYEES WILL NOT BE PERMITTED TO ENGAGE IN ACTIVITIES, WHICH ARE IN COMPETITION WITH THE BUSINESS ACTIVITIES OF RIVERVIEW HEALTH. (EXAMPLES MAY INCLUDE, BUT 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 WHICH THEY ENGAGE IN WHICH 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 REMUNERATION 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 AN EMPLOYEE'S WORK HOURS. ASSOCIATION FACILITIES, EQUIPMENT, LABOR OR SUPPLIES MAY NOT BE USED TO CONDUCT NON-RIVERVIEW 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 OR 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. CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED OFF ANNUALLY BY ALL EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE RIVERVIEW HEALTHCARE ASSOCIATION BOARD OF DIRECTORS DETERMINE THE COMPENSATION FOR THE CEO. MANAGEMENT POSITIONS COMPENSATION IS DETERMINED BY ADMINISTRATION OFFICERS, REVIEWED BY HUMAN RESOURCES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATIONS FINANCIAL STATEMENTS ARE SUMMARIZED AND MADE AVAILABLE TO THE PUBLIC AT THE ANNUAL MEETING. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A | DR. COLIN FENNELL: RIVERVIEW HEALTHCARE ASSOCIATION TIME ALLOCATION: EMPLOYMENT AS A DOCTOR: 40 HOURS PER WEEK BOARD OF DIRECTORS: 1 HOURS PER WEEK RIVERVIEW HEALTHCARE ASSOCIATION COMPENSATION: DOCTOR REPORTABLE COMPENSATION: $ 611,754 DOCTOR OTHER COMPENSATION: $ 34,064 BOARD REPORTABLE COMPENSATION: $ 0 BOARD OTHER COMPENSATION: $ 0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERVIEW HEALTHCARE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 SOUTH MINNESOTA ST | AddressLine1 |
| City | CROOKSTON | City |
| State | MN | State |
| ZIP Code | 56716 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411699589 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |