TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) DR JEFFREY EHNSTROM...................................................................... DIRECTOR/PHYSICIAN	40.00 .................	X				409,661	46,767
(2) DR TIMOTHY DIRKS...................................................................... DIRECTOR	1.00 .................	X				0	0
(3) HEATHER HIPP...................................................................... DIRECTOR	1.00 .................	X				0	0
(4) LOWELL LARSON...................................................................... DIRECTOR	1.00 .................	X				0	0
(5) TOM LUNDBERG...................................................................... DIRECTOR	1.00 .................	X				0	0
(6) JARED LUNDGREN...................................................................... DIRECTOR	1.00 .................	X				0	0
(7) STEVE WILSON...................................................................... DIRECTOR	1.00 .................	X				0	0
(8) CHRISTINE BRIGHT...................................................................... SECRETARY	1.00 .................	X	X			0	0
(9) CHAD GROSS...................................................................... TREASURER	1.00 .................	X	X			0	0
(10) MIKE PAULBECK...................................................................... VICE CHAIR	1.00 .................	X	X			0	0
(11) KATHLEEN RYAN...................................................................... CHAIR	1.00 .................	X	X			0	0
(12) KEN WESTMAN...................................................................... CEO	38.00 ................. 2.00		X			402,039	36,590
(13) CASEY JOHNSON...................................................................... CFO	38.00 ................. 2.00		X			239,131	43,937
(14) DR DAVID TAYLOR...................................................................... CMO	40.00 .................			X		573,564	45,646
(15) CYNTHIA BAKER...................................................................... COO	38.00 ................. 2.00			X		307,934	47,526
(16) DR JESSICA HODSON...................................................................... ER PHYSICAN	40.00 .................				X	407,421	53,691
(17) DR JIM HARRIS...................................................................... ER PHYSICAN	40.00 .................				X	391,473	44,976

(A) Name and business address	(B) Description of services	(C) Compensation
CUYUNA REGIONAL MEDICAL CENTER 320 E MAIN ST CROSBY,MN56441	MEDICAL/SURGICAL PROF SVCS	5,298,464
LIFE GUARD ANESTHESIA SERVICES INC 29561 395TH PLACE AITKIN,MN56431	ANESTHESIA PROF SVCS	1,952,759
MEDICAL SOLUTIONS LLC 1010 N 102ND ST 300 OMAHA,NE68114	HOURLY LABOR	1,792,922
CENTRAL MINNESOTA DIAGNOSTICS INC 150 10TH ST MILACA,MN56353	RADIOLOGY PROF SVCS	1,471,415
PREMIER SURGICAL ASSOCIATES PA 318 E MAIN ST CROSBY,MN56441	MEDICAL PROF SVCS	924,204
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 14

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2022

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER		Employer identification number 41-0745522

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD HEALTHCARE CENTER			Employer identification number 41-0745522
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

3,078

Total. Add lines 1c through 1i ....................................................................................................

3,078

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
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.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	536,857	656,179	593,667	542,002	558,828
b	Contributions ...	0	8,000		250	18,132
c	Net investment earnings, gains, and losses	50,366	-111,322	77,512	51,415	31,974
d	Grants or scholarships ...	15,000	16,000	15,000		26,932
e	Other expenditures for facilities and programs ...					40,000
f	Administrative expenses ....
g	End of year balance ......	572,223	536,857	656,179	593,667	542,002

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

25.479 %

Permanent endowment SchDMd Bullet

47.137 %

Term endowment SchDMd Bullet

27.383 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,684,922		1,684,922
b	Buildings ....	42,220,368	25,994,715	16,225,653
c	Leasehold improvements	1,143,461	200,607	942,854
d	Equipment ....	34,677,464	28,896,321	5,781,143
e	Other .....	39,320,895	3,741,938	35,578,957
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				60,213,529

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)INVESTMENT IN RIVERWOOD MEDICAL PROPERTIES, LLC				-1,400,312
(2)ASSETS LIMITED FOR RESERVE ACCOUNTS				959,966
(3)ASSETS LIMITED BY AGREEMENT FOR INTEREST RATE SWAP INSTRUMENTS				6,000,000
(4)BENEFICIAL INTEREST IN NET ASSETS-HOSPITAL FOUNDATION				6,630,853
(5)ASSETS LIMITED BY BOARD FOR FUNDED DEPRECIATION				3,074,367
(6)ASSETS LIMITED BY AGREEMENT FOR DEFERRED COMPENSATION				2,590,069
(7)INVESTMENT IN CENTRAL MINNESOTA DIAGNOSTICS, INC.				1,429,610
(8)ASSETS LIMITED BY AGREEMENT FOR WORKER'S COMPENSATION				259,387
(9)RIGHT-OF-USE LEASE ASSET				4,637,579
(10)INTEREST RATE SWAPS				1,888,061
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				26,069,580

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	5,364,549
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	100,768,202
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	3,906,406
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	811,022
e	Add lines 2a through 2d .....................			2e	4,717,428
3	Subtract line 2e from line 1..................			3	96,050,774
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	47,503
c	Add lines 4a and 4b....................			4c	47,503
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	96,098,277

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	94,312,024
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	134,818
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	435,368
e	Add lines 2a through 2d....................			2e	570,186
3	Subtract line 2e from line 1...................			3	93,741,838
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	976,237
c	Add lines 4a and 4b.....................			4c	976,237
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	94,718,075

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
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 CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2020.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	IMPLICIT PRICE CONCESSIONS -959,995. DECREASE IN INTEREST IN NET ASSETS - RIVERWOOD FOUNDATION -270,779. RIVERWOOD MEDICAL PROPERTIES, LLC REVENUE 126,000. ELIMINATIONS RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC 27,735. UNREALIZED GAIN ON INTEREST RATE SWAPS 1,888,061.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	SISU MEDICAL SOLUTIONS, LLC SCHEDULE K-1 ACTIVITY 31,261. GRANT EXPENSE NETTED WITH REVENUE 16,242.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RIVERWOOD MEDICAL PROPERTIES, LLC EXPENSES 561,368. ELIMINATION RELATED TO RIVERWOOD MEDICAL PROPERTIES, LLC -126,000.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	IMPLICIT PRICE CONCESSIONS 959,995. GRANT EXPENSE NETTED WITH REVENUE 16,242.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1,372,199		1,372,199	1.460 %
b	Medicaid (from Worksheet 3, column a) . . . . .	11,846,301	10,444,154	1,402,147	1.500 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	13,218,500	10,444,154	2,774,346	2.960 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	965,033		965,033	1.030 %
f	Health professions education (from Worksheet 5) . . .	9,330		9,330	0.010 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	974,363		974,363	1.040 %
k	Total. Add lines 7d and 7j .	14,192,863	10,444,154	3,748,709	4.000 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

959,995

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

26,211,474

Enter Medicare allowable costs of care relating to payments on line 5.....

27,546,145

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-1,334,671

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Other (describe)
1	RIVERWOOD HEALTHCARE CENTER 200 BUNKER HILL DRIVE AITKIN,MN56431 HTTPS://RIVERWOODHEALTHCARE.ORG/ 406244	X	X	X	X	N/A

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, PAGE 8

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, PAGE 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, PAGE 8

The FAP application form was widely available on a website (list url):

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	AITKIN COMMUNITY HOSPITAL DBA RIVERWOOD
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
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 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 PARTNERSHIPS.2) 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 THRU THE CHNA PROCESS, AND CONSIDERING HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION STATEMENT, GOALS, AND STRATEGIC PRIORITIES, IT WAS DETERMINED THAT RIVERWOOD WILL FOCUS ON DEVELOPING AND/OR SUPPORTING THESE STRATEGIES AND INITIATIVES TO IMPROVE:1) MENTAL HEALTH 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 HEALTH CARE SERVICES WILL ALSO HAVE A POSITIVE IMPACT IN THESE AREAS. AS FOR INJURY AND VIOLENCE, RIVERWOOD BELIEVES THAT THIS PRIORITY AREA FALLS WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. CONCLUSION:IN ADDITION TO SPECIFIC STRATEGIES AND MISSION DRIVEN PROGRAMS, RIVERWOOD CONTINUES TO MAINTAIN ITS HEALTH CARE HOME CERTIFICATION USING A TEAM-BASED APPROACH TO ADDRESS SOCIAL DETERMINATES OF HEALTH AND PATIENT NEEDS. EXPANDING THE ROLE OF MENTAL HEALTH RN THROUGH BEHAVIORAL HEALTH INTEGRATION WILL SUPPORT THE PROVIDER AND PROVIDE CARE COORDINATION FOR PATIENTS TO ASSIST THEM IN CONNECTING WITH APPROPRIATE COMMUNITY RESOURCES. WE HAVE COLLABORATED WITH A COMMUNITY WIDE TASKFORCE TO INCREASE MENTAL HEALTH AWARENESS. THE GOAL IS REDUCING 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. WEDNESDAY FARMER'S MARKETS WILL BE HELD ON CAMPUS AT RIVERWOOD 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. 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):	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 WAIT TIMES. IN SUPPORT OF SUBSTANCE ABUSE, RIVERWOOD HAS A MULTI-DISCIPLINARY CONTROLLED SUBSTANCE CARE TEAM TO ASSIST PATIENTS WITH OPIOID ADDICTIONS AND TO REDUCE PRESCRIBING OF SUCH MEDICINES. THE TEAM CONSISTS OF PHYSICIANS, NURSES, PHARMACISTS, AND SOCIAL WORKERS WHO MEET MONTHLY. RIVERWOOD HAS RECEIVED A GRANT FOR THE STATE OF MN TO AID IN CONTINUAL SUPPORT OF THE DRUG CRISES. 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."

Schedule H (Form 990) 2022

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address		Type of Facility (describe)
1	1 - RIVERWOOD AITKIN CLINIC 200 BUNKER HILL DRIVE AITKIN,MN56431	CLINIC
2	2 - RIVERWOOD MCGREGOR CLINIC 2 E CENTRAL AVENUE MCGREGOR,MN55760	CLINIC
3	3 - RIVERWOOD GARRISON CLINIC 27278 STATE HWY 18 GARRISON,MN56450	CLINIC
4
5
6
7
8
9
10

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
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 2023 MEDICARE COST REPORT.
PART I, LN 7 COL(F):	IMPLICIT PRICE CONCESSIONS FROM FINANCIAL STATEMENTS IS $959,995.
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. SEE THE GRADUATED BUCKET %'S BELOW: 0-60: 10%, 61-90: 15%, 91-120: 30%, 121-150: 40%, 151-360: 60%, 361+: 90%
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 VOLUNTEERED 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.
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

Schedule H (Form 990) 2022

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number
41-0745522

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) RIVERWOOD HEALTHCARE CENTER & COMMUNITY HOSPITAL FOUNDATION 200 BUNKER HILL AITKIN,MN56431	41-1738787	501(C)(3)	0	101,780	FMV	ADMINISTRATIVE EXPENSES	TO PROVIDE ADMINISTRATIVE SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) DOLLARS FOR SCHOLARS HEALTHCARE EDUCATION SCHOLARSHIP	3	4,500
(2) RIVERWOOD EMPLOYEE HIGH SCHOOL SENIOR STUDENT SCHOLARSHIP	6	1,500
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE HOSPITAL PAYS FOR CERTAIN ADMINISTRATIVE EXPENSES FOR THE FOUNDATION.

Schedule I (Form 990) 2022

Additional Data

Software ID:
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- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DR DAVID TAYLOR CMO	(i) (ii)	573,519 ------------- 0	0 ------------- 0	45 ------------- 0	12,200 ------------- 0	33,446 ------------- 0	619,210 ------------- 0	0 ------------- 0
2DR JESSICA HODSON ER PHYSICAN	(i) (ii)	407,376 ------------- 0	0 ------------- 0	45 ------------- 0	12,200 ------------- 0	41,491 ------------- 0	461,112 ------------- 0	0 ------------- 0
3DR JEFFREY EHNSTROM DIRECTOR/PHYSICIAN	(i) (ii)	409,616 ------------- 0	0 ------------- 0	45 ------------- 0	11,627 ------------- 0	35,140 ------------- 0	456,428 ------------- 0	0 ------------- 0
4KEN WESTMAN CEO	(i) (ii)	376,994 ------------- 0	25,000 ------------- 0	45 ------------- 0	7,139 ------------- 0	29,451 ------------- 0	438,629 ------------- 0	0 ------------- 0
5DR JIM HARRIS ER PHYSICAN	(i) (ii)	391,428 ------------- 0	0 ------------- 0	45 ------------- 0	11,842 ------------- 0	33,134 ------------- 0	436,449 ------------- 0	0 ------------- 0
6CYNTHIA BAKER COO	(i) (ii)	237,151 ------------- 0	70,738 ------------- 0	45 ------------- 0	11,767 ------------- 0	35,759 ------------- 0	355,460 ------------- 0	0 ------------- 0
7DR ERIK BOSTROM PROVIDER	(i) (ii)	292,958 ------------- 0	10,000 ------------- 0	45 ------------- 0	12,200 ------------- 0	33,647 ------------- 0	348,850 ------------- 0	0 ------------- 0
8DR TONY BLANKERS PROVIDER	(i) (ii)	283,193 ------------- 0	4,000 ------------- 0	45 ------------- 0	11,837 ------------- 0	33,857 ------------- 0	332,932 ------------- 0	0 ------------- 0
9TIMOTHY ARNOLD PROVIDER	(i) (ii)	270,008 ------------- 0	10,000 ------------- 0	45 ------------- 0	11,577 ------------- 0	34,560 ------------- 0	326,190 ------------- 0	0 ------------- 0
10CASEY JOHNSON CFO	(i) (ii)	202,036 ------------- 0	37,050 ------------- 0	45 ------------- 0	9,934 ------------- 0	34,003 ------------- 0	283,068 ------------- 0	0 ------------- 0
11TODD A SANDBERG CEO UNTIL 7/31/21 (FORMER OFFICER)	(i) (ii)	0 ------------- 0	0 ------------- 0	196,923 ------------- 0	0 ------------- 0	0 ------------- 0	196,923 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 4A	THE ORGANIZATION PAID TODD A. SANDBERG, FORMER CEO, $196,923 IN SEVERENCE PAYMENTS DURING CALENDAR YEAR 2022. THE TERMINATION TERMS ARE FROM AUGUST 1, 2021 TO JULY 31, 2022. MR. SANDBERG RECEIVED PAY TOTALING $320,000 AND BENEFITS TOTALING $14,300 RELATED TO HIS TERMINATION.

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number
41-0745522

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF AITKIN	41-6004918		05-17-2016	5,985,025	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
B	CITY OF MCGREGOR	41-0906736		05-17-2016	8,000,000	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
C	CITY OF TAMARACK	41-1315842		05-17-2016	8,000,000	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
D	CITY OF AITKIN	41-6004918		12-28-2017	9,732,000	RENOVATE, EXPAND, EQUIP CLINIC SPACE; BUILD 9 CHAIR KIDNEY DIALYSIS CENTER		X		X		X
	CITY OF MCGREGOR	41-0906736		12-22-2022	9,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF AITKIN	41-6004918		12-22-2022	10,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF TAMARACK	41-1315842		12-22-2022	10,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF GARRISON	41-0984999		12-22-2022	8,500,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,253,789		3,012,571		3,012,571		2,263,985
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	5,985,025		8,000,000		8,000,000		9,732,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	248,443		277,430		276,600		235,110
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	89,142		119,153		119,153		194,640
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	5,895,883		7,880,847		7,880,847		9,537,360
12 Other unspent proceeds .............	8,751,557		9,722,570		7,685,048		8,264,890
13 Year of substantial completion .............	2013		2013		2013		2019
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	BREMER CDE		BREMER CDE		BREMER CDE		BREMER CDE
c Term of hedge .........	1250.0000000000 %		1250.0000000000 %		1250.0000000000 %		1250.0000000000 %
d Was the hedge superintegrated? ......		X		X		X		X
e Was the hedge terminated? ........		X		X		X		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number
41-0745522

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF AITKIN	41-6004918		05-17-2016	5,985,025	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
B	CITY OF MCGREGOR	41-0906736		05-17-2016	8,000,000	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
C	CITY OF TAMARACK	41-1315842		05-17-2016	8,000,000	REFINANCE DEBT WHICH FINANCED CONSTRUCTION OF NEW HOSPITAL IN 2001		X		X		X
D	CITY OF AITKIN	41-6004918		12-28-2017	9,732,000	RENOVATE, EXPAND, EQUIP CLINIC SPACE; BUILD 9 CHAIR KIDNEY DIALYSIS CENTER		X		X		X
	CITY OF MCGREGOR	41-0906736		12-22-2022	9,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF AITKIN	41-6004918		12-22-2022	10,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF TAMARACK	41-1315842		12-22-2022	10,000,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X
	CITY OF GARRISON	41-0984999		12-22-2022	8,500,000	CONSTRUCT AND EQUIP 63,450 SQ FOOT NEW SURGERY CENTER ADDITION TO HOSPITAL		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,253,789		3,012,571		3,012,571		2,263,985
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	5,985,025		8,000,000		8,000,000		9,732,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	248,443		277,430		276,600		235,110
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	89,142		119,153		119,153		194,640
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	5,895,883		7,880,847		7,880,847		9,537,360
12 Other unspent proceeds .............	8,751,557		9,722,570		7,685,048		8,264,890
13 Year of substantial completion .............	2013		2013		2013		2019
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	BREMER CDE		BREMER CDE		BREMER CDE		BREMER CDE
c Term of hedge .........	1250.0000000000 %		1250.0000000000 %		1250.0000000000 %		1250.0000000000 %
d Was the hedge superintegrated? ......		X		X		X		X
e Was the hedge terminated? ........		X		X		X		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JENNIFER EHNSTROM	FAMILY MEMBER OF BOARD MEMBER JEFFREY EHNSTROM	21,777	EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Return Reference	Explanation
FORM 990, PART III, LINE 4A	"AITKIN COUNTY CARE HAS BEEN INSTRUMENTAL IN ASSISTING WITH COMMUNITY OUTREACH TO ORGANIZATIONS ON ONBOARDING WITH FIND HELP," SAID RACHEL JOHNSON, POPULATION HEALTH PROGRAM MANAGER AT RIVERWOOD. "THROUGH 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 NEEDED." 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. THE MINNESOTA DEPARTMENT OF HEALTH (MDH) HAS 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," SAID POPULATION HEALTH MANAGER RACHEL JOHNSON. "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 WENT LIVE IN JUNE 2023 WITH THE COMMUNITY RESOURCE QUESTIONNAIRE IN WHICH THE ORGANIZATION STARTED EVALUATING AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH WITH PATIENTS THROUGH THE RIVERWOOD CONNECTS PROGRAM. TO DATE RIVERWOOD HAS ASSESSED 1,352 UNIQUE PATIENTS AND DETERMINED THE TOP AREA OF NEED IS 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 HAS REFERRED SEVENTY-SEVEN PATIENTS AND ENROLLED FIFTY-NINE PATIENTS INTO ITS FOOD RX PROGRAM. POPULATION HEALTH PROGRAM MANAGER RACHEL JOHNSON ADDED, "WE ARE GRATEFUL TO OUR PARTNERS IN ASSISTING US IN MAKING THIS WORK POSSIBLE. AITKIN COUNTY CARE ASSISTED WITH IDENTIFYING THE NEED FOR A RESOURCE HUB, INCLUDING FINANCIAL AND ADMINISTRATIVE ASSISTANCE. THEY HAVE BEEN INSTRUMENTAL WITH COMMUNITY OUTREACH AND ONBOARDING COMMUNITY ORGANIZATIONS WITH FIND HELP. ADDITIONALLY, AITKIN COUNTY SHIP AND THE AITKIN FARMERS MARKET HUB HAVE BEEN INFLUENTIAL ON SETTING UP THE FOOD RX PROGRAM. THE FOOD RX PROGRAM WOULD NOT BE POSSIBLE WITHOUT THEIR SUPPORT WITH LOCAL FARMERS AND OUTREACH EFFORTS. RIVERWOOD CONNECTS IS NOT ONLY HELPING COMMUNITY MEMBERS IN NEED BUT SUPPORTING LOCAL SMALL BUSINESSES AND ORGANIZATIONS THROUGHOUT THE COUNTY AND REGION." THE MINNESOTA DEPARTMENT OF HEALTH HAS 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, PROACTIVE 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 ABOUT 324 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 HANDLING EMERGING PROBLEMS. THEY FOLLOW UP WITH PATIENTS REGULARLY, WHICH HELPS TO REDUCE CHRONIC DISEASE PROBLEMS AND NEW HEALTH ISSUES. I FEEL 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 RECOGNIZED BY BEING NAMED TO A LIST OF TOP 100 CRITICAL ACCESS HOSPITALS IN THE U.S., FOR THE SIXTH TIME IN THE PAST DECADE. 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.
FORM 990, PART III, LINE 4A	RIVERWOOD HEALTHCARE CENTER STRIVES TO DELIVER THE HIGHEST QUALITY PATIENT-CENTERED CARE. 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 IS CURRENTLY CONSTRUCTING A NEW SURGICAL WING. WITH THE NEED FOR MORE OPERATING ROOMS AND LARGER ROOMS, THIS WILL ALLOW ACCOMMODATING THE TECHNOLOGY OF A DA VINCI ROBOT, VELYS ORTHOPEDIC EQUIPMENT AND UROSKOP INTERVENTIONAL UROLOGY OPERATING ROOM TABLE. THIS EXPANSION ALLOWS US TO MEET OUR LARGER SURGERY VOLUMES, OFFERING PRIVACY NEEDS FOR PATIENTS WHO DESERVE HEALING AND RECOVERY. THE HOSPITAL'S NEW SURGERY SPACE WILL CONSIST 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 WILL ALSO INCLUDE APPROXIMATELY 12,000 SQUARE FEET OF CLINICAL SPACE FOR GENERAL SURGERY, UROLOGY AND OB/GYN. RIVERWOOD HEALTHCARE PURCHASED THE MCGREGOR PHARMACY, EFFECTIVE APRIL 20, 2023, OFFERING PHARMACY CUSTOMERS THE SAME LOCATION AND ENHANCED, HIGH-QUALITY SERVICES. RIVERWOOD PATIENTS RECEIVE THE SAME CARING AND PERSONALIZED APPROACH TO SERVICES AT THE MCGREGOR PHARMACY THAT RIVERWOOD PROVIDES ITS CLINIC AND HOSPITAL PATIENTS. RIVERWOOD CONTINUES TO BUILD COMPREHENSIVE CARE AND SERVICES TO OUR PATIENTS IN THE COMMUNITIES WE SERVE. TAKING OWNERSHIP OF THE MCGREGOR PHARMACY IS AN ADDITIONAL PATIENT SATISFIER OFFERING SPECIALIZED PHARMACEUTICAL SERVICES AND CONVENIENCE FOR OUR MCGREGOR PATIENTS. THIS IS JUST ONE MORE WAY WE DELIVER EXCEPTIONAL HEALTHCARE INTO THE FUTURE. WITH AN ELECTRONIC HEALTH RECORD TRANSITION UNDERWAY IN 2023, WE ARE CREATING A DIGITAL FRONT DOOR EXPERIENCE THAT WILL GIVE OUR PATIENTS MORE OWNERSHIP OVER THEIR CARE WHILE ADDING CONVENIENCE AND TIME-SAVING FEATURES. INTERNALLY, THIS CONVERSION GIVES RIVERWOOD MORE AUTONOMY AND FLEXIBILITY TO ADJUST AND STREAMLINE WORKFLOWS AND PROCESSES OF CARE, ALL DESIGNED FOR PERSONALIZATION OF THE SYSTEM TO BEST FIT OUR 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 5,940,941. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,940,941. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,360,464. MANAGEMENT AND GENERAL EXPENSES 1,620,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,980,723.
FORM 990, PART XI, LINE 9:	DECREASE IN INTEREST IN NET ASSETS OF RIVERWOOD FOUNDATION -270,779. SISU MEDICAL SOLUTIONS, LLC SCHEDULE K-1 ACTIVITY -31,261. UNREALIZED GAIN ON INTEREST RATE SWAPS 1,888,061.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

AITKIN COMMUNITY HOSPITAL DBA
RIVERWOOD HEALTHCARE CENTER

Employer identification number

41-0745522

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)RIVERWOOD HEALTH CARE CENTER FOUNDATION 200 BUNKER HILL DRIVE AITKIN,MN56431 41-1738787	SUPPORT	MN	501(C)(3)	LINE 12A, I	RIVERWOOD HEALTHCARE CENTER	Yes
(2)RIVERWOOD MEDICAL PROPERTIES LLC 200 BUNKER HILL DRIVE AITKIN,MN56431 82-3113322	SUPPORT	MN	501(C)(3)	LINE 12A, I	RIVERWOOD HEALTHCARE CENTER	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) RIVERWOOD FOUNDATION	C	478,130	FMV
(2) RIVERWOOD FOUNDATION	B	101,780	FMV
(3) RIVERWOOD MEDICAL PROPERTIES	K	126,000	FMV
(4) RIVERWOOD MEDICAL PROPERTIES	A	99	FMV

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	463,848	1,620,461
9	Program service revenue (Part VIII, line 2g) .........	87,225,506	92,703,428
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,240,912	305,703
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	811,859	1,468,685
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	91,742,125	96,098,277
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	123,405	130,111
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	41,245,271	45,063,758
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	47,709,144	49,524,206
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	89,077,820	94,718,075
19	Revenue less expenses. Subtract line 18 from line 12.......	2,664,305	1,380,202
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	122,550,858	133,201,757
21	Total liabilities (Part X, line 26).............	51,542,238	55,455,320
22	Net assets or fund balances. Subtract line 21 from line 20.....	71,008,620	77,746,437

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 81,102,291 including grants of $ 130,111 ) (Revenue $ 93,899,438 )
	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 2023, RIVERWOOD ADDED MEDICAL PROVIDERS TO ITS SPECIALTY CARE STAFF TO INCREASE ACCESS FOR RESIDENTS TO OBSTETRICS/GYNECOLOGY AND ENT PHYSICIANS. FOR PRIMARY CARE, RIVERWOOD CONTINUES TO USE DIGITAL TECHNOLOGY TO ENHANCE PATIENT CARE, INCLUDING CONTINUING TELEMEDICINE VIRTUAL VISITS FOR PRIMARY CARE AND SPECIALTY CARE, AND TAPS VIRTUAL RESOURCES FOR INPATIENT CARE AS WELL. DURING THE CORONAVIRUS PANDEMIC LIMITATIONS, RIVERWOOD HEALTHCARE CENTER BEGAN GIVING PATIENTS THE OPPORTUNITY TO MEET WITH THEIR HEALTH CARE PROVIDERS VIRTUALLY FROM HOME. ONGOING, IT OFFERS GREATER CONVENIENCE FOR THOSE WHO FOUND 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 2023. COMPREHENSIVE ADVANCED LIFE SUPPORT (CALS)- RIVERWOOD WAS THE FIRST HOSPITAL IN THE STATE OF MINNESOTA TO RECEIVE CALS DESIGNATION IN 2008 AND IT CONTINUES THROUGH TODAY. CALS CRITERIA REQUIRES ALL PROVIDERS WHO TREAT PATIENTS IN THE HOSPITAL BE CERTIFIED IN TRAUMA, ADVANCED CARDIAC LIFE SUPPORT (ACLS) AS WELL AS PEDIATRICS AND NEONATAL CARE CERTIFIED. CALS IS ONE OF THE PREMIER EDUCATION PROGRAMS FOR RURAL HEALTH CARE PROVIDERS. WITH 100% OF NURSES AND PROVIDERS TRAINED IN CALS AND SECURING RECOMMENDED EQUIPMENT, RIVERWOOD PROVES ITS COMMITMENT TO THE PEOPLE IT SERVES. RIVERWOOD HEALTHCARE CENTER WAS RECOGNIZED FOR EXCELLENCE IN WORKPLACE SAFETY AND HEALTH DURING THE 2023 MINNESOTA SAFETY AND HEALTH CONFERENCE. RIVERWOOD RECEIVED THE CONFERENCE MERITORIOUS ACHIEVEMENT: INCIDENCE RATES THAT ARE BETTER THAN THE INDUSTRY AVERAGE FOR AT LEAST THREE YEARS, AND A SCORE BETWEEN 50 AND 74 ON A 100-POINT SAFETY PROGRAM EVALUATION SCALE. FROM SAFE FACILITIES AND EQUIPMENT TO FOLLOWING THE BEST SAFETY PRACTICES, A FOCUS ON WORKPLACE SAFETY IS EMBEDDED IN ALL THAT WE DO AT RIVERWOOD. THE RIVERWOOD HEALTHCARE CENTER DIABETES SELF-MANAGEMENT EDUCATION PROGRAM HAS BEEN AWARDED CONTINUED RECOGNITION STATUS FROM THE AMERICAN DIABETES ASSOCIATION (ADA). RIVERWOOD'S PROGRAM WAS ORIGINALLY RECOGNIZED BY THE ADA IN 2005. THE PROGRAM IS A VOLUNTARY PROCESS THAT ASSURES THAT APPROVED EDUCATION SERVICES HAVE MET THE NATIONAL STANDARDS FOR DIABETES SELF-MANAGEMENT EDUCATION SERVICES. PROGRAMS THAT ACHIEVE RECOGNITION STATUS HAVE A STAFF OF KNOWLEDGEABLE HEALTH PROFESSIONALS WHO CAN PROVIDE HIGH QUALITY CARE AND INFORMATION ABOUT DIABETES MANAGEMENT FOR PARTICIPANTS. THIS DESIGNATION RECOGNIZES THE EXCELLENCE OF CARE PROVIDED TO PATIENTS WITH DIABETES WHO RECEIVE CARE FROM OUR DIABETES EDUCATION TEAM AT RIVERWOOD. WITH A MEDICAL PROVIDER'S REFERRAL, THOSE WITH DIABETES ARE OFFERED INDIVIDUAL OR GROUP EDUCATION SESSIONS TO SUCCESSFULLY MANAGE THIS CHRONIC DISEASE. RIVERWOOD HEALTHCARE CENTER EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR CRITICAL ACCESS HOSPITAL ACCREDITATION BY DEMONSTRATING CONTINUOUS COMPLIANCE WITH ITS PERFORMANCE STANDARDS. THE LATEST RESULTS FROM HOSPITAL CONSUMER ASSESSMENT OF HEALTH CARE PROVIDERS AND SYSTEMS (HCAHPS) SURVEYS SHOW THAT RIVERWOOD CONSISTENTLY GETS RATED FIVE STARS, THE HIGHEST RATING OF "EXCELLENCE" FROM THE PATIENTS IT SERVES. THE FIVE-STAR RATINGS ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES ARE FOR PATIENTS' EXPERIENCE OF THEIR HOSPITAL CARE. FACTORS INCLUDE IMPORTANT TOPICS LIKE HOW WELL NURSES AND DOCTORS COMMUNICATE, HOW RESPONSIVE HOSPITAL STAFF WERE TO NEEDS, AND CLEANLINESS AND QUIETNESS OF THE HOSPITAL ENVIRONMENT. THE FIVE-STAR RATING IS BASED ON HCAHPS SURVEY DATA FROM 2021 AND 2022. THE MINNESOTA DEPARTMENT OF HEALTH RECENTLY RECERTIFIED RIVERWOOD HEALTHCARE CENTER IN AITKIN 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 RECERTIFIED 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 MANY 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. AT THE RECENT 2023 MHA ANNUAL MEETING, 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 PROGRAM 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 JUNE 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. THE ONLINE PLATFORM "FIND HELP" WAS BUILT IN 2010 TO OFFER AN EASIER WAY TO FIND SOCIAL SERVICES AND TO CONNECT TO THEM DIRECTLY AND ELECTRONICALLY. WITH THE FINANCIAL AND ADMINISTRATIVE ASSISTANCE FROM AITKIN COUNTY CARE, RIVERWOOD IMPLEMENTED FIND HELP IN ITS FACILITY AND COMMUNITY WIDE.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses81,102,291

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) DR ERIK BOSTROM........................................................................ PROVIDER	40.00 .......................	X		303,003	0	45,847
(19) DR TONY BLANKERS........................................................................ PROVIDER	40.00 .......................	X		287,238	0	45,694
(20) TIMOTHY ARNOLD........................................................................ PROVIDER	40.00 .......................	X		280,053	0	46,137
(21) TODD A SANDBERG........................................................................ CEO UNTIL 7/31/21 (FORMER OFFICER)	38.00 .......................2.00		X	196,923	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,798,440	0	456,811

1	Briefly describe the organization’s mission or most significant activities: 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.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	558
6	Total number of volunteers (estimate if necessary) .............	6	100
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	460,980
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	479,048
e	Government grants (contributions)		1e	729,277

f	All other contributions, gifts, grants, and similar amounts not included above		1f	412,136

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,620,461

		Business Code
2a	NET PATIENT SERVICE REVENUE	621500	92,273,709	92,273,709
b	RETAIL PHARMACY	456110	429,719		429,719
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		92,703,428

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,577,398			1,577,398
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	800	40,631,984	7a
b	Less: cost or other basis and sales expenses	0	41,904,479	7b
c	Gain or (loss)	800	-1,272,495	7c
d	Net gain or (loss).........			-1,271,695			-1,271,695
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER REVENUE		900099	798,441	798,441
b	EQUITY IN EARNINGS OF AFFILIATES		900099	551,305	551,305
c	CAFETERIA		900099	241,414			241,414
d	All other revenue ....			-122,475	-153,736	31,261
e	Total. Add lines 11a–11d ......			1,468,685
12	Total revenue. See instructions.....			96,098,277	93,469,719	460,980	547,117

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	124,111	124,111
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	6,000	6,000
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,145,980	484,554	1,661,426
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	33,521,452	29,407,072	4,114,380
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,224,137	1,107,889	116,248
9	Other employee benefits .......	5,838,631	5,185,447	653,184
10	Payroll taxes ...........	2,333,558	2,037,785	295,773
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	178,785		178,785
c	Accounting ...........	165,890		165,890
d	Lobbying ...........	3,078		3,078
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,921,664	14,301,405	1,620,259
12	Advertising and promotion ....	9,420	61	9,359
13	Office expenses .......	2,564,728	1,850,112	714,616
14	Information technology ......	1,284	1,284
15	Royalties ..
16	Occupancy ...........	974,904	848,904	126,000
17	Travel ............	74,186	68,528	5,658
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	57,827	38,812	19,015
20	Interest ...........	1,011,387	707,197	304,190
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,969,730	3,345,086	624,644
23	Insurance ...	387,214		387,214
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS	12,285,752	12,285,752
b	MEDICAL SUPPLIES	7,529,489	7,378,055	151,434
c	REPAIRS & MAINTENANCE	1,373,695	1,329,681	44,014
d	PROVISION FOR UNCOLLECT	959,995	959,995
e	All other expenses	2,055,178	-365,439	2,420,617
25	Total functional expenses. Add lines 1 through 24e	94,718,075	81,102,291	13,615,784	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,152,994	1	3,748,573
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			13,507,358	4	15,928,909
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			3,455,407	8	4,586,049
9	Prepaid expenses and deferred charges ......			588,569	9	649,101
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	119,047,110
b	Less: accumulated depreciation	10b	58,833,581	32,151,234	10c	60,213,529
11	Investments—publicly traded securities .			56,857,602	11	21,460,425
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14	545,591
15	Other assets. See Part IV, line 11 ...........			14,837,694	15	26,069,580
16	Total assets. Add lines 1 through 15 (must equal line 33)...			122,550,858	16	133,201,757

17	Accounts payable and accrued expenses .....	13,415,597	17	18,133,078
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	22,690,112	20	22,329,478
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	10,624,363	23	9,628,215
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	4,812,166	25	5,364,549
26	Total liabilities. Add lines 17 through 25..	51,542,238	26	55,455,320

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	64,106,987	27	71,115,583
28	Net assets with donor restrictions ...........	6,901,633	28	6,630,854
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	71,008,620	32	77,746,437
33	Total liabilities and net assets/fund balances ........	122,550,858	33	133,201,757