OTTUMWA — River Hills Community Health Center weathered a once-in-a-century pandemic and had to think outside the box to keep providing services to patients.

In a way, it was all perfect.

The Ottumwa-based health center received a perfect score during an operational site visit last month by the federal Health Resources and Services Administration, which allows the facility to continue to receive annual grant funding.

Simply put, River Hills aced an audit of all its services, ranging from patient care to finances to partnerships with larger entities to conflicts of interest. Essentially no stone was left unturned, and HRSA did not find one thing out of compliance with River Hills, despite all the challenges of the past year.

"There's hardly been any health centers in Iowa that have ever had a perfect OSV, and it's not uncommon to have five to seven deficiencies that they cite you for," River Hills CEO Rick Johnson said. "It really is a collective effort for this to happen. It's a team effort, and we have excellent staff."

The visit, conducted virtually because of the pandemic, took three days in March and the hospital had to upload "hundreds of documents" to HRSA for review. It was a rigorous process that takes place every three years, but was delayed into 2021 because of the pandemic.

"Going in, we were pretty confident we were in good shape, but we were told to expect them to find some things, so we kind of were prepping for that," said Gina Throckmorton, River Hills' chief operations officer and chief financial officer. "So we were prepared for them to find things.

"As the days went on, we're like, 'I think we're going to make it. They don't think they're going to find anything,'" she said. "So that was exciting."

One of the stipulations for being federally qualified, as River Hills is, is that 51% of board members have to use the facility, and Johnson said "85% of our members do." However, one of the biggest perks to River Hills is its sliding-fee scale payment system, because it allows patients who either have little insurance or are low-income to pay for services.

"That's big with HRSA and something they really take a hard look at," Johnson said. "We have a very good payer mix, because we've tried over the years to demonstrate that we're here for everybody in the community. We need the private-insurer patients, the Medicare and Medicaid patients.

"You have to run it like a business, and having that good mix allows us to survive. You do everything you can so people feel confident that when they come to River Hills, they're going to get high-quality health care."

The center offers medical, pediatric, dental, women's health and family planning, behavioral health and telehealth.

River Hills, the fourth-largest health center in the state, has 183 employees across its five locations, and that total will likely exceed 200 before the end of the year as it opens up behavioral health clinics in Oskaloosa and Fairfield.

Plus, with the health center's use of telehealth and other evolving technologies, and the development of school-based partnerships for therapy, River Hills' best days may still be ahead.

Both Johnson and Throckmorton commended the staff's ability to adapt to challenging times.

"It just reinforced for me the excellent staff that we know we've always had," Johnson said. "We had to kind of figure things out on the fly. There were a lot of challenges because of the pandemic, but our staff was able to maneuver the challenges without lessening the quality of care we were providing to our patients."

Throckmorton agreed.

"I think it speaks volumes of our staff and our managers and our administrative team," Throckmorton said. "We all just work really good as a team. We had to look at alternative methods and look outside the box.

"It was just amazing," she said. "It was exhausting." 

— Chad Drury can be reached at, and on Twitter @ChadDrury


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