Community Benefit Insight - Tax-exempt hospital

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Sparrow Carson Hospital

Carson City Hospital

406 East Elm Street
Carson City, MI 48811

Bed count	103	Medicare provider number	230208	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 381490180

Display data for year:

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

7.4%

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	$ 0 0 %
Medicaid as % of operating expenses	$ 3,616,472 7.40 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 0 0 %
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.	$ 952 0.00 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 1,200 0.00 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	1
Physical improvements and housing	0
Economic development	0
Community support	1
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)	10
Physical improvements and housing	0
Economic development	0
Community support	10
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	$ 1,200 0.00 %
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	$ 1,200 100 %
Environmental improvements as % of community building expenses	$ 0 0 %
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	$ 0 0 %
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	$ 357,830 0.73 %
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	$ 45,414 12.69 %

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 $ 30110175 including grants of $ 0) (Revenue $ 33181044)
SPARROW CARSON HOSPITAL (SCCH) IS A 61-BED, ACUTE CARE HOSPITAL LOCATED IN CENTRAL MICHIGAN. IT IS THE OLDEST OSTEOPATHIC HOSPITAL IN MICHIGAN, FOUNDED IN 1936 BY EMMETT BINKERT, DO. SINCE THIS TIME, SCCH HAS BEEN COMMITTED TO SERVING THE RESIDENTS IN A FOUR-COUNTY AREA. SCCH CURRENTLY OPERATES A SHORT-TERM, ACUTE-CARE FACILITY AND SEVERAL SATELLITE CLINICS OFFERING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES, PHYSICIAN SERVICES, PRIMARILY TO PATIENTS IN THE CARSON CITY, MICHIGAN AREA, INCLUDING GRATIOT, MONTCALM, CLINTON, AND IONIA COUNTIES. SCCH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE SCCH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE UNDER ARRANGEMENTS WITH VARIOUS GOVERNMENTAL INSURANCE PROGRAMS. SCCH PROVIDES SIGNIFICANT CARE TO THE LOCAL INDIGENT POPULATION FOR WHICH REIMBURSEMENT FOR SERVICES RENDERED IS GENERALLY LESS THAN THE COST OF PROVIDING SUCH SERVICES AS PART OF ITS OBLIGATION TO THE LOCAL COMMUNITY. SCCH ALSO PROVIDES SERVICES TO INDIGENT PATIENTS UNDER THE MEDICAID PROGRAM AT PAYMENT AMOUNTS LESS THAN THE COST OF THE SERVICES PROVIDED.

4B (Expenses $ 13614954 including grants of $ 0) (Revenue $ 11102573)
SPARROW MEDICAL GROUP (SMG) FACILITIES INCLUDING PRIMARY CARE PRACTICES (SMG ASHLEY, SMG CARSON, SMG FOWLER, SMG GREENVILLE, SMG ITHACA, SMG PEDIATRICS CARSON CITY, AND SMG STANTON) AND SPECIALIST OFFICES (SMG CARSON GENERAL SURGERY,SMG CARSON ORTHOPEDICS, SMG CARSON OBGYN, SMG CARSON PAIN MANAGEMENT)

4C (Expenses $ 456108 including grants of $ 0) (Revenue $ 431412)
PHYSICAL REHABILITATION CENTER PROVIDES PHYSICAL THERAPY, AQUA THERAPY, NEUROLOGICAL, AND VESTIBULAR/BALANCE CONDITIONS AND MOVEMENT ANALYSIS FOR YOUR BEST OUTCOME, AND MCKENZIE CERTIFIED TREATMENT FOR SPINE.

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
OTHER PROGRAM SERVICES INCLUDE THE OPERATION OF THE PHYSICAL REHABILITATION CENTER AND THE FOLLOWING SPARROW MEDICAL GROUP (SMG) FACILITIES INCLUDING: SMG CARSON GENERAL SURGERY,SMG CARSON ORTHOPEDICS, SMG CARSON OBGYN, SMG ASHLEY, SMG CARSON, SMG FOWLER, SMG GREENVILLE, SMG ITHACA, SMG PEDIATRICS CARSON CITY, AND SMG STANTON.

Facility Information

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

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 3E
THE SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED AND DOCUMENTED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT.

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 5
AS A SUPPLEMENT TO THE HEALTHY CAPITAL COUNTIES (HCC) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), INTERVIEWEES AND FOCUS GROUP PARTICIPANTS WERE SOLICITED FROM A WIDE VARIETY OF COMMUNITY RESIDENTS WITHIN THE PRINCIPAL AREAS SERVED BY SPARROW HEALTH SYSTEM HOSPITALS. AMONG THOSE SOLICITED WERE COMMUNITY LEADERS AND HEALTH CARE LEADERS; STATE AND LOCAL ELECTED OFFICIALS; PHYSICIANS AND OTHER HEALTH CARE PROVIDERS OR WORKERS; LEADERS AND MEMBERS OF RACIAL, ETHNIC, AND RELIGIOUS MINORITIES; EDUCATORS; STUDENTS; RETIREES; SOCIAL SERVICE PROVIDERS; AND OTHERS. MINORITY GROUPS WITH WHOM THESE ISSUES WERE DISCUSSED INCLUDED AFRICAN AMERICANS, MEMBERS OF THE MUSLIM COMMUNITY FROM SEVERAL DIFFERENT ETHNIC BACKGROUNDS, INTERNATIONAL STUDENTS, AND MEMBERS OF THE EAST INDIAN COMMUNITY. HEALTHCARE ISSUES WITHIN THE HISPANIC COMMUNITY WERE ADDRESSED BY A PHYSICIAN THAT SERVES THE HISPANIC COMMUNITY. INTERNATIONAL STUDENTS WERE FROM CHINA AND THE MIDDLE EAST.

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 6A
SPARROW HEALTH SYSTEM, CONSISTING OF SIX COMMUNITY HOSPITALS, THREE OF WHICH ARE LOCATED IN THE THREE-COUNTY GREATER LANSING REGION: - EDWARD W SPARROW HOSPITAL, LANSING, MI - SPARROW SPECIALTY HOSPITAL, LANSING, MI - SPARROW CLINTON HOSPITAL, ST. JOHNS, MI - SPARROW IONIA HOSPITAL, IONIA, MI - SPARROW CARSON HOSPITAL, CARSON CITY, MI - SPARROW EATON HOSPITAL, CHARLOTTE, MI - MCLAREN GREATER LANSING - EATON RAPIDS MEDICAL CENTER

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 6B
- MICHIGAN PUBLIC HEALTH INSTITUTE - BARRY-EATON DISTRICT HEALTH DEPARTMENT - INGHAM COUNTY HEALTH DEPARTMENT - MID-MICHIGAN DISTRICT HEALTH DEPARTMENT

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 11
SPARROW CARSON HOSPITAL HAS DEVELOPED AN IMPLEMENTATION STRATEGY FOR THE TOP TWO PRIORITY NEEDS THAT WERE IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE TOP NEEDS IDENTIFIED WERE IMPROVED ACCESS TO HEALTHCARE AND INCREASED AWARENESS OF EXISTING COMMUNITY RESOURCES. FOR EACH OF THE NEEDS IDENTIFIED MULTIPLE KEY OBJECTIVES WERE IDENTIFIED TO CREATE A STRATEGY ON HOW TO MEET THE NEEDS. FOR EACH KEY OBJECTIVE AN IMPLEMENTATION STRATEGY WAS CREATED, INCLUDING TIMING FOR THE IMPLEMENTATION AND GOALS TO MONITOR THE SUCCESS OF MEETING THE NEEDS. OTHER NEEDS WERE IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE TOP TWO NEEDS IDENTIFIED.

FACILITY 1, SPARROW CARSON HOSPITAL - PART V, LINE 24
ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM THE HOSPITAL'S FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED UPON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 7
THE DEFINITION OF A COMMUNITY BENEFIT IS A SERVICE OR PROGRAM THAT THE HOSPITAL PROVIDES TO PROMOTE HEALTH AND HEALING AS A RESPONSE TO COMMUNITY NEEDS. COMMUNITY BENEFITS USUALLY GENERATE A LOW OR NEGATIVE FINANCIAL RETURN, RESPOND TO PUBLIC HEALTH NEEDS, INVOLVE EDUCATION OR RESEARCH THAT IMPROVES THE OVERALL COMMUNITY HEALTH, AND RESPOND TO THE NEEDS OF SPECIAL POPULATIONS SUCH AS PERSONS LIVING IN POVERTY AND OTHER DISENFRANCHISED PERSONS. THE COSTING METHODOLOGY USED IS COST TO CHARGE RATIO. THE COST TO CHARGE RATIO IS FIGURED BY TAKING THE TOTAL EXPENSES EXCLUSIVE OF BAD DEBT AND DIVIDING THAT BY GROSS PATIENT REVENUE AND OTHER OPERATING REVENUE.

SCHEDULE H, PART III, LINE 2
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE COST TO CHARGE RATIO IS USED IN DETERMINING BAD DEBT INFORMATION.

SCHEDULE H, PART III, LINE 3
IN REVIEWING ACCOUNTS CLASSIFIED AS BAD DEBT, THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3, REFLECTS PATIENTS WHO HAD PREVIOUSLY QUALIFIED FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT, BUT WHO AT THE TIME OF SERVICES, WERE NO LONGER ELIGIBLE FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT OR THE SERVICES PROVIDED WERE NOT COVERED BENEFITS. THE HOSPITAL FURTHER REVIEWED THESE PATIENTS TO MAKE A DETERMINATION OF THE PATIENTS' ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY.

SCHEDULE H, PART III, LINE 4
BAD DEBT FOOTNOTE - SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS, REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, IS A RATIO OF COSTS TO CHARGES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES.

SCHEDULE H, PART III, LINE 9B
THE CHARGES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE ARE WRITTEN OFF THE SYSTEM TO CHARITY CARE AT THE TIME THE PATIENT'S CHARITY CARE STATUS IS DETERMINED. AS SUCH, NO FURTHER COLLECTION EFFORTS TAKE PLACE.

SCHEDULE H, PART VI, LINE 2
SPARROW CARSON HOSPITAL RESPONDS TO THE HEALTHCARE NEEDS OF ITS ENTIRE SERVICE AREA. ITS DOORS ARE OPEN TO ALL THOSE WHO NEED HEALTHCARE SERVICES. INFORMATION ABOUT HEALTHCARE NEEDS IS RECEIVED THROUGH PARTNERSHIPS WITH LOCAL NON-PROFITS, GOVERNMENT AGENCIES AND OTHER HEALTHCARE ORGANIZATIONS, SUCH AS THE MID-MICHIGAN DISTRICT HEALTH DEPARTMENT AND THE IONIA COUNTY HEALTH DEPARTMENT - WHICH, TOGETHER, MONITOR THE MORTALITY RATES AND CAUSES IN CLINTON, GRATIOT, IONIA AND MONTCALM COUNTIES. HOSPITAL SERVICE RECORDS AND PATIENT SATISFACTION SURVEYS - MANAGED BY PRESS GANEY - ALSO PROVIDE FEEDBACK TO HOSPITAL STAFF ABOUT THE NEEDS OF THE COMMUNITY.

SCHEDULE H, PART VI, LINE 3
ALTHOUGH NOT SPECIFICALLY OUTLINED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL USES THE FOLLOWING METHODS TO PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY: WITHIN THE COMMUNITY SERVED THE POLICY WAS POSTED ON THE HOSPITAL FACILITY'S WEBSITE; THE POLICY WAS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS OR WAITING ROOMS; THE POLICY WAS POSTED IN THE HOSPITAL FACILITY'S ADMISSIONS OFFICE; THE POLICY WAS AVAILABLE UPON REQUEST. PATIENTS WERE MADE AWARE OF THE POLICY UPON ADMISSION. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS CURRENTLY UNDER REVIEW, AND THE HOSPITAL IS CONSIDERING ADDING SPECIFIC INFORMATION RELATED TO THE METHODS USED TO PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY WITHIN THE COMMUNITY SERVED.

SCHEDULE H, PART VI, LINE 4
"SPARROW CARSON HOSPITAL (SCCH) IS A 61-BED, ACUTE CARE HOSPITAL LOCATED IN CENTRAL MICHIGAN. IT IS THE OLDEST OSTEOPATHIC HOSPITAL IN MICHIGAN, FOUNDED IN 1936 BY EMMETT BINKERT, DO. SINCE THIS TIME SCCH HAS BEEN COMMITTED TO SERVING THE RESIDENTS OF COMMUNITIES IN A FOUR-COUNTY AREA. THE HOSPITAL'S GOVERNING BODY CONSISTS PRIMARILY OF VOLUNTEER MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. IN THE FALL OF 1996, SPARROW CARSON BECAME A PART OF CARSON HEALTH NETWORK (CHN). CHN WAS INTRODUCED TO WORK AS AN UMBRELLA UNDER WHICH ALL THE INDIVIDUAL HEALTHCARE ENTITIES ARE CONTAINED. CHN INCLUDES SPARROW CARSON HOSPITAL, FAMILY MEDICINE PRACTICES AND SEVERAL SPECIALTY CLINICS OFFERING A WIDE VARIETY OF SERVICES. THE FAMILY MEDICINE PROFESSIONAL, MEDICAL STAFF, IN COOPERATION WITH HOSPITAL BASED SPECIALISTS, SERVES PATIENTS IN ASHLEY, CARSON CITY, FOWLER, GREENVILLE, ITHACA, AND STANTON. THESE OFFICES FALL INTO 4 COUNTIES WHICH INCLUDE MONTCALM, IONIA, CLINTON AND GRATIOT COUNTIES. ALL AREAS ARE DESIGNATED AS RURAL BASED WITH AN AVERAGE OF 20,210 HOUSEHOLDS WITH AN AVERAGE HOUSEHOLD SIZE OF 2-7 PEOPLE. THE AVERAGE INCOME PER HOUSEHOLD IS 42,590 WHILE 6.20% OF ALL FAMILIES ARE BELOW THE POVERTY LEVEL. ALSO INCLUDED IN THIS GEOGRAPHIC AREA ARE 5 OTHER HOSPITALS: SPARROW CLINTON HOSPITAL, SPARROW IONIA HOSPITAL, SPECTRUM HEALTH UNITED CAMPUS, SHERIDAN COMMUNITY HOSPITAL, AND MID-MICHIGAN MEDICAL CENTER GRATIOT. IN ADDITION TO ACUTE HOSPITAL CARE, SCCH PROVIDES A VARIETY OF ADVANCED SERVICES, RANGING FROM AN INTENSIVE/CORONARY CARE UNIT TO MULTIPLE OUTPATIENT SERVICES. SCCH ALSO PROVIDES 24 - HOUR EMERGENCY ROOM CARE. PHYSICIANS ARE AVAILABLE TO YOU ANY TIME AT THE HOSPITAL, DAY OR NIGHT FOR EMERGENCY OR NON-EMERGENCY MEDICAL ASSISTANCE. ANY SURPLUS FUNDS AVAILABLE TO THE HOSPITAL ARE USED FOR FACILITY AND EQUIPMENT IMPROVEMENTS IN ORDER TO PROVIDE BETTER PATIENT CARE. THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 INCLUDED PROVISIONS FOR IMPLEMENTING HEALTH INFORMATION TECHNOLOGY UNDER THE HEALTH INFORMATION TECHNOLOGY FOR ECONOMIC AND CLINICAL HEALTH ACT(""HITECH""). THESE PROVISIONS WERE DESIGNED TO INCREASE THE USE OF ELECTRONIC HEALTH RECORDS(""EHR"") TECHNOLOGY AND ESTABLISH REQUIREMENTS FOR A MEDICARE AND MEDICAID INCENTIVE PAYMENTS PROGRAM BEGINNING IN 2011 FOR ELIGIBLE HOSPITALS AND PROVIDERS THAT ADOPT AND MEANINGFULLY USE CERTIFIED EHR TECHNOLOGY. DURING 2012, SPARROW CARSON HOSPITAL DEMONSTRATED THE MEANINGFUL USE OF ITS CERTIFIED EHR TECHNOLOGY AND WAS ABLE TO RECOGNIZE APPROXIMATELY 1.3 MILLION IN REVENUE FOR HITECH INCENTIVES FROM MEDICARE AND MEDICAID. THESE INCENTIVE PAYMENTS ALLOW THE HOSPITAL TO PROVIDE ADDITIONAL QUALITY SERVICES TO THOSE IN THE COMMUNITY."

SCHEDULE H, PART VI, LINE 6
SPARROW CARSON HOSPITAL IS A CONTROLLED SUBSIDIARY OF SPARROW HEALTH SYSTEM. SPARROW HEALTH SYSTEM IS A NON-PROFIT, COMMUNITY GOVERNED, INTEGRATED HEALTH DELIVERY AND FINANCIAL SYSTEM SERVING MID-MICHIGAN. SPARROW HEALTH SYSTEM PROVIDES SERVICES TO THE COMMUNITIES IT SERVES THROUGH ITS CONTROLLED SUBSIDIARIES: PHYSICIAN HEALTH PLAN, PHYSICIAN HEALTH NETWORK, EDWARD W SPARROW HOSPITAL, SPARROW CLINTON HOSPITAL, SPARROW SPECIALTY HOSPITAL, SPARROW CARSON HOSPITAL, SPARROW DEVELOPMENT, INC, SPARROW COMMUNITY CARE, SPARROW IONIA HOSPITAL, SPARROW FOUNDATION, SPARROW EATON HOSPITAL, AND SPARROW CLINICAL RESEARCH INSTITUTE.

SCHEDULE H, PART VI, LINE 5
SPARROW CARSON HOSPITAL PROVIDES A SPEAKERS BUREAU LIST OF PHYSICIANS AND STAFF MEMBERS WHO ARE WILLING TO GO OUT INTO THE COMMUNITY AND SPEAK ON A VARIETY OF HEALTHCARE, QUALITY-OF-LIFE, AND GENERAL-INTEREST TOPICS TO SCHOOL CHILDREN, BUSINESS CLUBS, AND OTHER NON-PROFIT ORGANIZATIONS. SPARROW CARSON HOSPITAL'S ACTIVITIES PROMOTE THE HEALTHCARE OF THE COMMUNITY BY EDUCATING AND PROVIDING EASY ACCESSIBLE HEALTHCARE WITH A 24- HOUR EMERGENCY DEPARTMENT. OUTSIDE PHYSICIANS CAN APPLY FOR PRIVILEGES AT SPARROW CARSON HOSPITAL THROUGH A PROCESS TO TREAT AND PROVIDE MEDICAL CARE AT THE HOSPITAL. IN ADDITION, SPARROW CARSON HOSPITAL IS COMPRISED OF SEVEN HOSPITAL-OWNED PHYSICIAN CLINICS IN A RURAL SETTING. FREE AND REDUCED RATE SPORTS PHYSICALS ARE PROVIDED AT SELECTED CLINICS.

SCHEDULE H, PART VI, LINE 7
MICHIGAN

Operating expenses	$ 48,890,776
Total amount spent on community benefits as % of operating expenses	$ 3,617,424 7.40 %