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.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
SPARROW HEALTH SYSTEM
Employer identification number
38-2542859
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 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% 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.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
(A)
EDWARD W SPARROW HOSPITAL
381360584
3
Yes
Yes
Yes
0
(B)
SPARROW COMMUNITY CARE
382543305
9
Yes
Yes
Yes
0
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
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 fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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
.......................
b
33 1/3% support test—2012.
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
.....................
17a
10%-facts-and-circumstances test—2013.
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 IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
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 IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 in 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 IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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
........
b
33 1/3% support tests—2012.
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
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
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 to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
SPARROW HEALTH SYSTEM
Employer identification number
38-2542859
Return Reference
Explanation
FORM 990
ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART IV, QUESTION 4 - THE ORGANIZATION DOES NOT ENGAGE IN DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION DOES HAVE MEMBERSHIPS IN VARIOUS TRADE ASSOCIATIONS THAT USE A PORTION OF THE DUES PAID TO THE TRADE ASSOCIATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THE APPLICABLE TRADE ASSOCIATION INDUSTRIES, THUS INDIRECTLY BENEFITING THE ORGANIZATION. THE PERCENTAGE OF DUES ALLOCATED TO THIS INDUSTRY-WIDE LOBBYING ACTIVITY IS MINOR AND IS NOT CONSIDERED BY THE ORGANIZATION AS LOBBYING ACTIVITIES REQUIRED FOR DISCLOSURE ON SCHEDULE C, PART II.
FORM 990, PAGE 2, PART III, LINE 4A
THOMSON REUTERS. IN 2012, SHS BECAME A MEMBER OF THE MAYO CLINIC CARE NETWORK, A NON-OWNERSHIP COLLABORATIVE ARRANGEMENT. SHS IS A MICHIGAN NON STOCK, NONPROFIT TAX-EXEMPT CORPORATION, AND IS THE PARENT CORPORATION OF THE FOLLOWING TAX-EXEMPT, 501 (C)(3) ENTITIES: EDWARD W. SPARROW HOSPITAL ASSOCIATION (SPARROW HOSPITAL), SPARROW CLINTON HOSPITAL, SPARROW IONIA HOSPITAL, SPARROW SPECIALTY HOSPITAL, SPARROW COMMUNITY CARE, SPARROW CLINICAL RESEARCH INSTITUTE, AND SPARROW FOUNDATION. SPARROW FOUNDATION SERVES AS THE FUNDRAISING ARM OF SHS. EACH OF THESE ENTITIES FILES THEIR OWN 990 RETURNS. SHS IS ALSO THE PARENT CORPORATION OF PHYSICIANS HEALTH PLAN (PHP), A MICHIGAN NONPROFIT, TAX-EXEMPT HEALTH MAINTENANCE ORGANIZATION, AS WELL AS PHYSICIANS HEALTH NETWORK (PHN), A MICHIGAN NONPROFIT, TAX-EXEMPT CORPORATION. BOTH OF THESE COMPANIES ARE TAX-EXEMPT UNDER IRS CODE 501 (C) (4) AND FILE THEIR OWN 990 RETURNS. LASTLY, SHS IS THE PARENT CORPORATION OF SPARROW DEVELOPMENT, INC. (SDI), A MICHIGAN STOCK, FOR-PROFIT CORPORATION. SDI INCLUDES, AS MENTIONED ABOVE, THE MICHIGAN ATHLETIC CLUB (MAC), AS WELL AS THE MAC RESTAURANT, AND ST. LAWRENCE OR MANAGEMENT COMPANY, LLC.
FORM 990, PAGE 6, PART VI, LINE 7A
THE PRESIDENT OF THE EDWARD W. SPARROW HOSPITAL MEDICAL STAFF IS A BOARD MEMBER OF THE SPARROW HEALTH SYSTEM BOARD. THE EDWARD W. SPARROW HOSPITAL MEDICAL STAFF PRESIDENT IS ELECTED BY THE MEDICAL STAFF OF THE HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 11B
COPIES OF THE 2013 FORM 990 ARE REVIEWED BY MANAGEMENT. THE FORM 990 COPIES WERE PROVIDED AT THE SEPTEMBER 2014 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON.
FORM 990, PAGE 6, PART VI, LINE 12C
1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON).
FORM 990, PAGE 6, PART VI, LINE 15A
THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, PAGE 6, PART VI, LINE 15B
THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE ON SEVERAL INTERNET WEBSITES, INCLUDING THE EMMA.MSRB AND MHA WEBSITES, AS WELL AS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VII
PART VII, SECTION A, COLUMN (E) REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS - PAYMENTS TO GREG BROGAN FOR BROKER'S SALES COMMISSIONS FOR PHP INSURANCE COMPANY (457,892).
FORM 990, PART IX, LINE 11G
LOSSES FROM SUBSIDIARIES 0 1,274,698 0
FORM 990, PART XI, LINE 9
INCREASE IN NET ASSETS: 0 SCH RESTRICTED FUND INCOME 1,462,393 AFFILIATE NET INCOME 66,524,052 FOUNDATION RESTRICTED FUND INCOME 3,552,025 FOUNDATION CAPITAL GRANTS 105,723 UNFUNDED PENSION OBLIGATION 112,185,985 OPEB 960,628 DECREASE IN NET ASSETS: 0 LANSING MEDICAL DENTAL BUILDING CONS. 506,744 FDN ASSETS RELEASED FROM RESTRICTION 1,014,276 OTHER 3,253
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.