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Community Health Needs Assessment Report The Health of Aitkin County Riverwood Healthcare Center, Aitkin, Minnesota September 30, 2013 1

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Community Health Needs Assessment Report

CHNA Riverwood Healthcare Center

Community Health Needs Assessment ReportThe Health of Aitkin CountyRiverwood Healthcare Center, Aitkin, Minnesota

September 30, 2013Community Health Needs Assessment Riverwood Healthcare CenterTable of ContentsIntroduction.page 4Acknowledgements...page 5Executive Summary..page 6Community Assessment Process...page 7Description of Process and Methods.page 7Data Sources.page 8Public Health Inputpage 9Community Description.page 11Demographic Data.page 13Population TrendsHousehold TrendsEthnicityAgeWorkforceSocioeconomicCommunity Systems Data...page 19 Healthy Community Data Key Indicators.page 20Bridge to Health Survey Prioritization Process of CHNA Needs.page 23Community Input Communication of Results..page 39Strategies for Implementation.page 39Riverwoods Addressing of NeedsConclusion.page 42 Attachments:Community Health ResourcesAttachment ARiverwood Wellness ResourcesAttachment B

IntroductionThe Health of Aitkin County is a Community Health Needs Assessment (CHNA) developed by Riverwood Healthcare Center, in partnership with other health and wellness organizations. This document fulfills the requirements for community hospitals, as set forth by the Patient Protection and Affordable Care Act (PPACA).The Patient Protection and Affordable Care Act set additional criteria for community hospitals to maintain their tax exempt 501c (3) status. This requirement applies for tax years beginning after March 3, 2012, and must be completed at least every three years, with input from the broader community including public health experts. This plan meets the requirements of IRS Notice 2011-52, which specifies information that needs to be included in the CHNA, including implementation strategies that address the issues identified by the assessment. The required information is contained in sections in this report, as summarized below. Community Assessment Process Community Description Demographic Data Community Systems Data Healthy Community Indicators Prioritization Process of CHNA Needs Communication of Results Strategies for Implementation Conclusion

AcknowledgementsSpecial thanks to the many individuals and organizations that assisted with the completion of the Community Health Needs Assessment process. Most specifically to the Core Project Team who provided input and guidance on the project. Thanks also to the many Riverwood Healthcare Center staff who assisted during various phases including Arlene Wheaton and Connie Gretschmann. Special thanks to Shelli Urness Consulting, HBH Associates, and Health Planning and Management Resources, Inc. for their expertise and involvement. I especially want to thank the many community members who provided input via the Community Feedback Sessions and Telephone Interviews. An engaged community has contributed to the success of Riverwood Healthcare Center since our inception in 1955, and we have partnered with the community to meet the health and wellness needs of the residents and visitors of Aitkin County and the surrounding area. This assessment has been a true community endeavor.Chad CooperCEO, Riverwood Healthcare CenterCHNA Core Project Team Members:Jayne Anderson, Riverwood Healthcare Center, Aitkin, MinnesotaCynthia Bennett, Aitkin County Public Health, Aitkin, MinnesotaLiz Dean, Riverwood Healthcare Center, Aitkin, MinnesotaMike Hagen, Riverwood Healthcare Center, Aitkin, MinnesotaJohn Hodson, Aitkin ISD #1 Community Education, Aitkin, MinnesotaLisa Kruse, McGregor ISD #4 Community Education, McGregor, Minnesota Beth Leaf, Aitkin County CARE, Aitkin, MinnesotaAlison Matalamaki, Aicota Healthcare Center, Aitkin, MinnesotaHeidi Olesen, Aitkin ISD #1, Aitkin, Minnesota Dan Schletty, Riverwood Healthcare Center, Aitkin, Minnesota Judy Turner, Riverwood Healthcare Center, Aitkin, MinnesotaShelli Urness, Shelli Urness Consulting, Brainerd, Minnesota

Executive Summary

Riverwood Healthcare Center (RHCC) operates a 25-bed critical access hospital serving Aitkin County and surrounding communities in north central Minnesota, with full service primary care clinics in Aitkin, Garrison and McGregor. Patients can access urgent care and a wide range of specialty care at our integrated hospital and clinic in Aitkin.

Our facility has achieved several designations that demonstrate our commitment to outstanding delivery of medical care. These include Level III Trauma Center, Level I Heart attack program protocol in affiliation with the Minneapolis Heart Institute at Abbott-Northwestern Hospital, and Comprehensive Advanced Life Support Hospital.

Riverwood delivers top quality medical care delivered with a team of caring healthcare professionals. Since 1955, we've been committed to providing our community with a comprehensive array of medical services close to home. Since 1955, we have expanded our portfolio of clinical services, added medical staff members, as well as increased the programs and number of sites to access care. Despite this growth in the range and extent of services, we have long realized that the full measure of accountability to the communities we serve is to improve and maintain health and wellness.

The Health of Aitkin County report is a comprehensive community health needs assessment (CHNA). The report outlines community health needs based on primary and secondary data sources. This report is intended to give Riverwood, our staff, and our community information on county health indicators that will serve to guide strategic activities and programs, and chart the course for future community health initiatives. Improving and sustaining community health is a collaborative effort that integrates many stakeholders including county public health, school districts, nonprofit organizations, and many other public and private entities. This CHNA report is the product of an 18-month process that sought community input, medical staff input, involved key representatives such as public health, and selected primary and secondary data sources to identify target areas and implementation plans.

Health and wellness is an issue of concern for all of us, and we hope that the information in this report creates conversation and action among the private and public sector, so that we all work to improve the health of our county.

It is Riverwoods intention to continue to use research and data on a three-year rotating cycle, as this allows time to make some changes, recruit any needed personnel, develop more services, and communicate to the community the services available.

Community Assessment Process

In order to fulfill the new requirements set forth by the IRS, Riverwood Healthcare Center has undertaken a community health needs assessment (CHNA), the purpose of which is to gain input on community health needs and identify gaps and barriers to service, with the ultimate goal of better serving the health and wellness needs of Aitkin County.

Description of Process and Methods

RHCC enlisted the services of Shelli Urness Consulting to design a project plan and coordinate the construction of the CHNA and report.

Project Overview

The Community Health Needs Assessment is a new federal requirement for private, non-profit hospitals including Riverwood Healthcare Center (RHCC). Part of the Patient Protection and Affordable Care Act (ACA), the Community Health Needs Assessment is the requirement of additional criteria for Riverwood and other hospitals to maintain their tax-exempt, 501(c) (3) status. This requirement applies for tax years beginning after March 23, 2012. A CHNA must be completed at least every three years with input from the broader community, including public health experts. The CHNA describes how Riverwood will address needs identified in the community health needs assessment as well as identify any needs not being addressed and explain why not, and contain an implementation strategy. Riverwood Healthcare Center has contracted with Shelli Urness Consulting to facilitate the CHNA Project in conjunction with a Project Team of Riverwood Healthcare Center staff and other key stakeholders previously identified.

In addition, Riverwood regularly conducts specific research on its services and community awareness. Health Planning and Management Resources, Inc. (HPMRI) conducted primary research in both 2008 and 2011 to help RHCC Management better understand the needs of the communities they serve. HPNRU completed telephone surveys-one in 2008 and one in 2011- of 400 randomly selected households in the market area. Because the related questions were asked for all household members, information was obtained for well over 500 persons residing in the market area. The telephone calls and analysis of the results were completed by professional market research firms. RHCCs management has used this information in the development of its strategic plan, including development of new services to serve the community needs.

HBH Consultants obtained input from residents in Riverwoods primary service communities: Aitkin, Garrison and McGregor. Through community input sessions telephone interviews and email questionnaires, we have evaluated perceptions regarding health and wellness resources available through both Riverwood and the wider community and have identified some missing links. Details of community input are detailed later in this report.

Project Approach

RHCC took a phased approach to the CHNA.

- Phase 1 Planning

- Phase 2 Compiling/collection

- Phase 3 Strategy analysis

- Phase 4 Action/execution

- Phase 5 Evaluation and measurement

(Phase 1 - PlanningStep 1- Engage Shelli Urness ConsultingStep 2-Compile Project TeamStep 3 Inventoryof Existing Resources 3Phase 3 - StrategyStep 6- Prioritize NeedsStep 7-