Community Benefit Insight - Tax-exempt hospital

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International Falls Memorial Hospital Association

Intl Falls Memorial Hospital

1400 Highway 71
International Falls, MN 56649

Bed count	25	Medicare provider number	241322	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 410726171

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

14.98%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 68,288 0.21 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 9,070 0.03 %
Subsidized health services as % of operating expenses	$ 4,700,606 14.71 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 7,451 0.02 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 1,450 0.00 %
Community building* as % of operating expenses	$ 46,885 0.15 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 46,885 0.15 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 26,885 57.34 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 20,000 42.66 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 496,351 1.55 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 25405883 including grants of $ 20000) (Revenue $ 33511420)
PROVIDED HEALTH CARE SERVICES TO THE COMMUNITY OF INTERNATIONAL FALLS AND SURROUNDING AREA. IN ADDITION TO PROVIDING DIRECT PATIENT CARE AND IN FURTHERANCE OF ITS CHARITABLE PURPOSE, RAINY LAKE MEDICAL CENTER (RLMC) PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY INCLUDING OFFERING VARIOUS COMMUNITY BASED SERVICE PROGRAMS, CASH CONTRIBUTIONS TO NON-PROFIT AGENCIES, THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS, AND STAFF TIME TO MENTORING/JOB SHADOWING. ADDITIONALLY, A NUMBER OF HEALTH RELATED EDUCATION 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. RLMC ALSO ACTIVELY PROMOTES ITS COMMUNITY CARE PROGRAM, WHICH PROVIDES FREE OR REDUCED COST HEALTHCARE TO PATIENTS WHO ARE UNABLE TO PAY FULLY FOR SERVICES RECEIVED. THE ORGANIZATION DISCONTINUED LABOR AND DELIVERY SERVICES IN 2021. WE STILL PROVIDE OBGYN SERVICES, JUST NOT LABOR AND DELIVERY.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

RAINY LAKE MEDICAL CENTER
"PART V, SECTION B, LINE 5: IN ADDITION TO GATHERING DATA FROM SECONDARY SOURCES, A CHNA SURVEY WAS DEPLOYED TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. COMMUNITY INPUT FROM 25 LOCAL EXPERT ADVISORS WAS RECEIVED. SURVEY RESPONSES STARTED SEPTEMBER 22ND, 2019, AND ENDED ON OCTOBER 14TH, 2019. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A ""WISDOM OF CROWDS"" METHOD WHERE EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. A LIST OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA WAS DEVELOPED. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE LIST OF HEALTH NEEDS, INCLUDING THE OPPORTUNITY TO LIST ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. THE RANKED NEEDS WERE DIVIDED INTO TWO GROUPS: ""SIGNIFICANT AND ""OTHER IDENTIFIED NEEDS."" THE LOCAL EXPERT ADVISORS WERE ASKED TO SELF-IDENTIFY THEMSELVES INTO ANY REPRESENTATIVE CLASSIFICATIONS WITH THE FOLLOWING RESULTS: PUBLIC HEALTH EXPERTISE (8) DEPARTMENTS AND AGENCIES WITH RELEVANT DATA/INFORMATION REGARDING HEALTH NEEDS (8) PRIORITY POPULATIONS (12) REPRESENTATIVE/ MEMBER OF CHRONIC DISEASE GROUP OR ORGANIZATION (3) REPRESENTS THE BROAD INTEREST OF THE COMMUNITY (21)."

RAINY LAKE MEDICAL CENTER
PART V, SECTION B, LINE 6B: QUORUM HEALTH RESOURCES ASSISTED WITH THE DEVELOPMENT OF RLMC'S COMMUNITY HEALTH NEEDS ASSESSMENT.

RAINY LAKE MEDICAL CENTER
PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7A & 10A:HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2022/10/RLMC-2019-CHNA.PDF

RAINY LAKE MEDICAL CENTER
PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA:- HEALTHCARE AFFORDABILITY/ACCESSIBILITY- MENTAL HEALTH- HEALTHCARE EDUCATION/PREVENTATIVE CARE- EMERGENCY ROOM SERVICES- DRUG/SUBSTANCE/ALCOHOL ABUSE- OBESITY/OVERWEIGHTTHE ORGANIZATION WILL NOT ADDRESS THE FOLLOWING NEEDS IDENTIFIED IN ITS MOST RECENT CHNA BECAUSE OF RESOURCE CONSTRAINTS AND THE AVAILABILITY OF OTHER RESOURCES IN THE COMMUNITY:- MENTAL HEALTH;- DRUG/SUBSTANCE/ALCOHOL ABUSE: DUE TO THE SIMILAR SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO ADDRESS THESE THREE NEEDS, WE GROUPED THESE NEEDS TOGETHER. - OBESITY/OVERWEIGHT.IN 2021 THE FACILITY TOOK THE FOLLOWING ACTIONS TO ADDRESS HEALTHCARE AFFORDABILITY/ACCESSIBILITY, HEALTHCARE EDUCATION/PREVENTATIVE CARE, AND EMERGENCY ROOM SERVICES:-11 HYPERTENSIVE PATIENTS WITH ELEVATED B/P WERE FOLLOWED IN 2021 AND LOANED A CUFF FOR ONE OR MORE TWO WEEK MONITORING PERIODS. THE RESULTS WERE MONITORED BY THE POPULATION HEALTH NURSE EVERY 2 WEEKS AND THE PCP WAS PROVIDED THE RESULTS AT THE END OF THE MONITORING PERIOD OR SOONER IF NEEDED. REDUCED PATIENT CONTACT DURING COVID RESULTED IN FEWER PATIENT VISITS AND LOWER NUMBERS. - 29 DIABETIC PATIENTS WERE FOLLOWED IN 2021 TO PROVIDE EDUCATION ON DIABETES MANAGEMENT, OVERSITE OF BLOOD SUGAR RESULTS, A1C GOALS, DIETARY EDUCATION, AND FOOD DIARY MONITORING. PCP RECEIVED REPORTS OF PATIENT PROGRESS VIA EMR DOCUMENTATION AND REPORTING IN PERSON AS NEEDED. - THE CONTRACTUAL CHANGES THAT WERE BROUGHT ABOUT IN 2020 AS A RESULT OF PROLONGED NEGOTIATION WITH OUR ER STAFFING COMPANY ALLOWED US TO DEVELOP A CORE GROUP OF RELIABLE ER MEDICAL PROVIDERS, RESULTING IN IMPROVED SERVICE, CARE, AND CUSTOMER SATISFACTION FROM OUR ER STAFFING COMPANY. THE STAFFING COMPANY'S CMO CONTINUED TO PERFORM MONTHLY RANDOM CHART REVIEWS TO ASSESS AND IMPROVE THE QUALITY OF THEIR PROVIDER'S DOCUMENTATION. RLMC CONTINUED TO SHARE ED PROVIDER-SPECIFIC SATISFACTION DATA AND PATIENT SURVEY COMMENTS WITH THE ED PROVIDERS TO PROMOTE SELF-IMPROVEMENT.-A COMMUNITY HEALTH FAIR THAT HAD BEEN PLANNED FOR 2021 WAS POSTPONED DURING COVID.

RAINY LAKE MEDICAL CENTER
PART V, SECTION B, LINE 15E: THE CONTACT PHONE NUMBER IS LISTED ON THE WEBSITE AND PROVIDED IN ALL STATEMENTS AND LETTERS MAILED, AND A BUSINESS CARD IS INCLUDED IN THE APPLICATION PACKET.

RAINY LAKE MEDICAL CENTER
PART V, SECTION B, LINE 16J: WORK CLOSELY WITH COUNTY SERVICES AND COMMUNITY SENIOR ADVOCATE.

PART V, SECTION B, LINE 16A
HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2022/10/FINANCIAL-ASSISTANCE-POLICY-CHARITY-CARE.PDF

PART V, SECTION B, LINE 16B
HTTPS://RAINYLAKEMEDICAL.COM/WP-CONTENT/UPLOADS/2022/11/FILLABLE-NEW-RLMC-COMMUNITY-CARE-APPLICATION-EFFECTIVE-11-30-2021.PDF

PART V, SECTION B, LINE 16C
HTTPS://RAINYLAKEMEDICAL.COM/RESOURCES/FINANCIAL-INFORMATION/

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 924,184.

PART II, COMMUNITY BUILDING ACTIVITIES:
"RLMC INVESTS RESOURCES TOWARDS EMERGENCY PREPAREDNESS, PARTICULARLY A ""DECONTAMINATION TEAM"" THAT CONDUCTS DRILLS THROUGHOUT THE YEAR. THE TEAM IS SKILLED IN SETTING UP A PORTABLE DECONTAMINATION TENT, DRESSING IN AN APPROPRIATE LEVEL OF PPE AND PRACTICING DECONTAMINATION PATIENTS. RLMC ALSO SUPPORTS EFFORTS TO HAVE THE SAFE REMOVAL AND TREATMENT OF GARBAGE AND WASTE PRODUCTS. RLMC ALSO PROVIDES SUPPORT TO AN EDUCATIONAL INSTITUTION IN THE AREA TO HELP TRAIN HEALTH PROFESSIONALS."

PART III, LINE 2:
THE AMOUNT REPORTED ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THE RESPECTIVE CLASS OF PATIENTS.

PART III, LINE 3:
THE HOSPITAL DOES NOT HAVE A WAY TO REASONABLY ESTIMATE THE AMOUNT OF IMPLICIT PRICE CONCESSIONS THAT ARE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE.

PART III, LINE 4:
SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, WAS NOT SIGNIFICANT.

PART III, LINE 8:
RLMC IS A CRITICAL ACCESS HOSPITAL. THERE WAS A SURPLUS IN 2021, HOWEVER, REGARDLESS OF SHORTFALL OR SURPLUS, THE HOSPITAL PROVIDES SERVICES TO THESE PATIENTS BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE 2021 MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.

PART III, LINE 9B:
RLMC WILL NOT REFER AN ACCOUNT TO A THIRD-PARTY DEBT COLLECTION AGENCY UNLESS RLMC HAS GIVEN THE PATIENT REASONABLE OPPORTUNITY TO SUBMIT A FINANCIAL ASSISTANCE APPLICATION IF THE FACTS AND CIRCUMSTANCES SUGGEST THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. INCLUDING FOR EXAMPLE, IF THE PATIENT IS UNINSURED OR IS ON MINNESOTA CARE, MEDICAL ASSISTANCE, OR OTHER RELIEF BASED ON NEED. IF A PATIENT SUBMITS AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, RLMC WILL SUSPEND ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S APPLICATION HAS BEEN PROCESSED AND THE PATIENT HAS BEEN NOTIFIED OF THE DECISION.

PART VI, LINE 2:
IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED EVERY 3 YEARS, COMMUNITY HEALTH FAIRS ARE HELD WHERE COMMUNITY MEMBERS CAN PROVIDE FEEDBACK ON THEIR HEALTH CARE NEEDS. A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) HAS ALSO BEEN FORMED WHICH PROVIDES A LINK BETWEEN THE COMMUNITY AND THE ORGANIZATION. RLMC HAS A LARGE FOOTPRINT WITHIN THE COMMUNITY WITH INVOLVEMENT IN MANY SERVICE AND COMMUNITY BASED GROUPS, SPONSORING THE COMMUNITY CHRISTMAS PARADE, PLANNING ASSISTANCE WITH THE FOURTH OF JULY PARADE, SPONSORING HALLOWEEN PUMPKINPALOOSA, AND CONTRIBUTING SUPPORT TO MANY LOCAL HEALTH AND EDUCATION RELATED PROGRAMS.

PART VI, LINE 3:
RLMC HAS STAFF THAT ARE CERTIFIED MNSURE NAVIGATORS, WHICH ENABLES US TO ASSIST OUR PATIENTS IN COMPLETING THE APPLICATION PROCESS ON THE HEALTH EXCHANGE TO SEE IF THEY QUALIFY FOR INSURANCE OR A MEDICAID PLAN. RLMC COMMUNICATES OUR FINANCIAL ASSISTANCE PROGRAM TO PATIENTS IN THE FOLLOWING MANNER: 1. PATIENTS ARE GIVEN A FINANCIAL ASSISTANCE BROCHURE WITH A MNSURE HEALTH EXCHANGE INSERT AT THE TIME OF SERVICE. 2. STATEMENTS AND LETTERS ARE SENT TO PATIENTS OFFERING FINANCIAL ASSISTANCE. 3. PHONE CALLS ARE MADE TO PATIENTS TO DISCUSS AND OFFER FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE MNSURE APPLICATION PROCESS. 4. ALL EMPLOYEES ARE EDUCATED ANNUALLY ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND THREE EMPLOYEES ARE EDUCATED TO COMPLETE AND SUBMIT MNSURE APPLICATIONS TO THE STATE FOR PROCESSING. 5. UPON REQUEST, FINANCIAL ASSISTANCE PACKETS WITH APPLICATIONS FOR BOTH OUR FINANCIAL ASSISTANCE PROGRAM AND THE MNSURE PROGRAM ARE SENT OR GIVEN TO PATIENTS. 6. THE RLMC WEBSITE DISPLAYS PAYMENT OPTIONS WHERE OUR FINANCIAL ASSISTANCE PROGRAM IS DISCUSSED. 7. ONE OF THE REQUIREMENTS FOR RLMC FINANCIAL ASSISTANCE IS A DENIAL FROM THE COUNTY IN REGARD TO FINANCIAL ASSISTANCE UNLESS THEY ARE ENROLLED IN THE MN SENIOR PROGRAM. WE OFFER TO ASSIST THEM WITH THEIR MEDICAL ASSISTANCE APPLICATION. 8. SIGNAGE COMMUNICATING THE PROGRAM TO PATIENTS IS DISPLAYED IN MANY AREAS OF THE PATIENT CARE AREA OF THE FACILITY. 9. FINANCIAL COUNSELORS ATTEND HEALTH FAIRS AND OTHER EVENTS IN THE COMMUNITY TO PROMOTE THE PROGRAM AND ANSWER ANY QUESTIONS. 10. RLMC HAS PARTNERED WITH NUMEROUS COMMUNITY SERVICE PARTNERS TO PROMOTE OUR FINANCIAL ASSISTANCE PROGRAM AND MNSURE NAVIGATOR AVAILABILITY. THE COMMUNITY SERVICE PARTNERS ARE GIVEN FINANCIAL ASSISTANCE AND MNSURE INFORMATION TO SHARE WITH THEIR PATRONS AND BUSINESS CARDS OF OUR FINANCIAL COUNSELING STAFF. RLMC STAFF MEETS WITH OUR SERVICE PARTNERS FOR INPUT REGARDING OUR PROGRAMS, TO REPLENISH BROCHURES AND INFORMATION AND TO UPDATE THEM WITH ANY CHANGES.

PART VI, LINE 4:
RLMC'S PRIMARY SERVICE AREA (PSA) IS KOOCHICHING COUNTY, MINNESOTA. THE COUNTY IS LARGE AND SPARSELY POPULATED (LESS THAN 4.3 PERSONS PER SQUARE MILE) WITH MOST OF THE POPULATION CENTERED IN INTERNATIONAL FALLS. OTHER NEARBY COMMUNITIES INCLUDE LITTLEFORK, BIG FALLS, RANIER, BIRCHDALE AND LOMAN. THE PSA HAS AN ESTIMATED POPULATION OF LESS THAN 13,000 AND POPULATION DECLINE IS PROJECTED TO CONTINUE WHILE THE NUMBER OF PERSONS OVER 65 IS EXPECTED TO RISE EVEN MORE.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN

PART VI, LINE 5:
REPRESENTATION ON THE BOARD OF TRUSTEES IS 100% LOCAL AS ALL TRUSTEES ARE ACTIVE AND INVOLVED MEMBERS OF THE LOCAL COMMUNITY. RLMC HAS IN PLACE AN OPEN MEDICAL STAFF MODEL AND HAS SPECIALISTS FROM SEVERAL DIFFERENT HEALTH CARE SYSTEMS PROVIDING CARE TO PATIENTS. THE ORGANIZATION HAS RECENTLY INVESTED OVER $8 MILLION IN EXPANSION AND RENOVATION OF THE CURRENT FACILITY IN ORDER TO PROVIDE BETTER PATIENT CARE AND MORE LOCAL CARE, ELIMINATING THE NEED TO TRAVEL 100+ MILES TO RECEIVE CARE. THE ORGANIZATION ALSO CONTINUES TO EXPAND THE BREADTH OF SPECIALTY SERVICES OFFERED LOCALLY ON AN OUTREACH BASIS. EMERGENCY SERVICES ARE OFFERED 24/7, 365 DAYS A YEAR TO ALL NEEDING CARE. BECAUSE OF ITS REMOTE LOCATION, IF CHEMOTHERAPY SERVICES WERE NOT OFFERED IN THE COMMUNITY, RESIDENTS WOULD HAVE TO TRAVEL 100+ MILES TO RECEIVE THIS CRITICAL SERVICE. THE ORGANIZATION RECENTLY ESTABLISHED A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) TO ALLOW FOR COMMUNITY INPUT.

Operating expenses	$ 31,963,224
Total amount spent on community benefits as % of operating expenses	$ 4,786,865 14.98 %