TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CHRISTOPHER E HERALD MD...................................................................... CHIEF OF STA	40.00 .................	X		399,640	0	52,442
(2) DAVID J FREESTONE MD...................................................................... BOARD MBR/PH	40.00 .................	X		397,836	0	45,502
(3) KIRA CARTER-ROBERTSON...................................................................... BOARD MEMBER	2.00 ................. 40.00	X		0	315,214	38,895
(4) WILLIAM ROESER...................................................................... INTRM PRESID	2.00 ................. 40.00	X	X	0	288,321	45,027
(5) ROBERT SEALS...................................................................... SECR/MED DIR	40.00 .................	X	X	164,402	0	48,432
(6) RODERICK COY...................................................................... BOARD MEMBER	2.00 .................	X		928	0	0
(7) GARY REETZ...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(8) BRENT WILSON...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(9) RICHARD SCHROEDER...................................................................... BOARD CHAIR	2.00 .................	X	X	0	0	0
(10) CAROL PRIEBE WILES...................................................................... VICE CHAIR	2.00 .................	X		0	0	0
(11) JEAN SOUTHWARD...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(12) SONNY HOUSE...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(13) DENNIS SWAN...................................................................... PRES & CEO -	................. 40.00		X	0	979,797	221,221
(14) PAULA REICHLE...................................................................... SR VP - CFO	................. 40.00		X	0	512,290	102,116
(15) LINDA REETZ...................................................................... CNO	20.00 ................. 20.00		X	0	220,424	31,610
(16) MARK BRISBOE...................................................................... CFO	40.00 ................. 13.00		X	0	193,973	35,088
(17) MATTHEW J THOMPSON...................................................................... PRESIDENT -P	40.00 .................		X	86,379	0	19,057

(A) Name and business address	(B) Description of services	(C) Compensation
PHYSICIAN ANESTHESIA SRV PC 1200 E MICHIGAN AVE STE 370 LANSING,MI489121897	STAFFING SERVCS	1,125,301
AMERICAN HEALTHCARE SERVICES ASSOC PO BOX 945 TRAVERSE CITY,MI496850945	STAFFING SERVCS	414,030
TEACHOUT SECURITY SEOLUTIONS G-2348 STONE BRIDGE DR FLINT,MI496850945	SEC SERVICES	109,616
GRAND RAPIDS SURGICAL ASSOCIATION 1009 44TH ST SW SUITE 101 WYOMING,MI49509	STAFFING SVCS	108,574

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 4

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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 ....................... right arrow

33 1/3% support test—2017. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2018. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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 ....... right arrow

33 1/3% support tests—2017. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization SPARROW CARSON HOSPITAL

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization SPARROW CARSON HOSPITAL		Employer identification number 38-1490180

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization SPARROW CARSON HOSPITAL			Employer identification number 38-1490180
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	4,297,975	3,986,792	3,707,924	3,411,165
b	Contributions ...	314,065	114,433	191,313	361,583
c	Net investment earnings, gains, and losses	-48,873	211,750	102,555	-49,824
d	Grants or scholarships ...	15,000	15,000	15,000	15,000
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	4,548,167	4,297,975	3,986,792	3,707,924

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	615,000		615,000
b	Buildings ....	15,511,248	4,504,191	11,007,057
c	Leasehold improvements
d	Equipment ....	16,814,864	7,675,491	9,139,373
e	Other .....	89,995	15,480	74,515
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				20,835,945

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) LONG TERM DEPOSITS				2,130,747
(2) JOINT VENTURES				316,079
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,446,826

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
PROFESSIONAL LIABILITY CLAIMS RESERV	440,000
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	440,000
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

SCHEDULE D, PAGE 2, PART V, LINE 4

SPARROW CARSON HOSPITAL DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW FOUNDATION AND SPARROW CLINTON HOSPITAL. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW CARSON HOSPITAL, SPARROW FOUNDATION, AND SPARROW CLINTON HOSPITAL. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENT.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	226,448		226,448	0.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	9,383,714	4,623,314	4,760,400	8.830 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	9,610,162	4,623,314	4,986,848	9.250 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	38,120		38,120	0.070 %
f	Health professions education (from Worksheet 5) . . .	127,803	37,209	90,594	0.170 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	165,923	37,209	128,714	0.240 %
k	Total. Add lines 7d and 7j .	9,776,085	4,660,523	5,115,562	9.490 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

797,665

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

41,877

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

8,215,178

Enter Medicare allowable costs of care relating to payments on line 5.....

8,143,020

Subtract line 6 from line 5. This is the surplus (or shortfall)........

72,158

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Other (describe)
1	SPARROW CARSON HOSPITAL 406 E ELM STREET CARSON CITY,MI48811 WWW.SPARROW.ORG 1060000095	X	X	X	X	URGENT CARE

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SPARROW CARSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.SPARROW.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.SPARROW.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SPARROW CARSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 200.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.SPARROW.ORG

The FAP application form was widely available on a website (list url):

WWW.SPARROW.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.SPARROW.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	SPARROW CARSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SPARROW CARSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
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 FIVE 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 - MCLAREN GREATER LANSING - HAYES GREEN BEACH MEMORIAL HOSPITAL - 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.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?12
Name and address		Type of Facility (describe)
1	SMG ITHACA 114 N MAIN ST ITHACA,MI48847	GENERAL MEDICAL OUTPATIENT CLINIC
2	SMG CARSON 102 S THIRD ST SUITE 100 BOX 277 CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
3	PHYSICAL REHABILITATION CARE CENTER 602 E ELM STREET CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
4	SPARROW CARSON HOME CARE 406 E ELM STREET CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
5	SMG GREENVILLE 1014 E WASHINGTON GREENVILLE,MI48838	GENERAL MEDICAL OUTPATIENT CLINIC
6	SMG PEDIATRIC ADOLESCENT SPECIALIST 245 S SECOND ST BOX 847 CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
7	SMG STANTON 545 N STATE ST BOX 638 STANTON,MI48888	GENERAL MEDICAL OUTPATIENT CLINIC
8	SMG ASHLEY 320 S STERLING ST BOX 96 ASHLEY,MI48806	GENERAL MEDICAL OUTPATIENT CLINIC
9	SMG PAIN MANAGEMENT 102 S THIRD ST SUITE 300 CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
10	SMG ORTHOPEDICS AND GENERAL SURGERY 102 S THIRD ST SUITE 400 BOX 326 CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
11	HOSPITALISTS 406 E ELM STREET CARSON CITY,MI48811	GENERAL MEDICAL OUTPATIENT CLINIC
12	SMG FOWLER 11017 W THIRD ST BOX 19 FOWLER,MI48835	GENERAL MEDICAL OUTPATIENT CLINIC

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	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.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	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.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	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.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	BAD DEBT FOOTNOTE - SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8 - MEDICARE EXPLANATION	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.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	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.
PART VI, LINE 2 - NEEDS ASSESSMENT	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.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	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 THE METHODS USED TO PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY WITHIN THE COMMUNITY SERVED.
PART VI, LINE 4 - COMMUNITY INFORMATION	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, LYONS, MAPLE RAPIDS 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.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	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. THE HOSPITAL ALSO MAINTAINS A MONTHLY BROWN BAG LUNCH SERIES FEATURING SIMILAR TOPICS, WHICH IS HELD INSIDE THE HOSPITAL AND OPEN TO THE COMMUNITY. 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.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	SPARROW CARSON HOSPITAL IS A WHOLLY-OWNED 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 WHOLLY-OWNED AND 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, AND SPARROW CLINICAL RESEARCH INSTITUTE.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	MICHIGAN

Schedule H (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1CHRISTOPHER E HERALD MD CHIEF OF STAFF	(i) (ii)	381,295 -------------	15,859 -------------	2,486 -------------	16,350 -------------	36,092 -------------	452,082 -------------	-------------
2DAVID J FREESTONE MD BOARD MBR/PHYSICIAN	(i) (ii)	256,414 -------------	140,285 -------------	1,137 -------------	8,100 -------------	37,402 -------------	443,338 -------------	-------------
3KIRA CARTER-ROBERTSON BOARD MEMBER	(i) (ii)	------------- 314,321	------------- 200	------------- 693	------------- 8,100	------------- 30,795	------------- 354,109	-------------
4WILLIAM ROESER INTRM PRESIDENT/CEO	(i) (ii)	------------- 279,522	-------------	------------- 8,799	------------- 24,200	------------- 20,827	------------- 333,348	-------------
5ROBERT SEALS SECR/MED DIRECTOR	(i) (ii)	162,120 -------------	750 -------------	1,532 -------------	25,587 -------------	22,845 -------------	212,834 -------------	-------------
6DENNIS SWAN PRES & CEO - SHS	(i) (ii)	------------- 927,328	-------------	------------- 52,469	------------- 172,836	------------- 48,385	------------- 1,201,018	-------------
7PAULA REICHLE SR VP - CFO - SHS	(i) (ii)	------------- 487,496	-------------	------------- 24,794	------------- 54,240	------------- 47,876	------------- 614,406	-------------
8LINDA REETZ CNO	(i) (ii)	------------- 219,962	-------------	------------- 462	------------- 6,420	------------- 25,190	------------- 252,034	-------------
9MARK BRISBOE CFO	(i) (ii)	------------- 193,475	------------- 100	------------- 398	------------- 6,091	------------- 28,997	------------- 229,061	-------------
10PARUTAPPA BHIMALLI MD PHYSICIAN	(i) (ii)	457,849 -------------	23,696 -------------	25,571 -------------	8,100 -------------	50,369 -------------	565,585 -------------	-------------
11MICHAEL RACINE MD PHYSICIAN	(i) (ii)	396,779 -------------	15,333 -------------	728 -------------	16,350 -------------	36,919 -------------	466,109 -------------	-------------
12MICHELLE BECHER PHYSICIAN	(i) (ii)	352,046 -------------	29,740 -------------	1,136 -------------	8,250 -------------	45,115 -------------	436,287 -------------	-------------
13ALBERTO BETANCOURT PHYISICIAN	(i) (ii)	354,736 -------------	14,044 -------------	3,771 -------------	7,376 -------------	21,140 -------------	401,067 -------------	-------------
14JOSE MALDONADO MD PHYSICIAN	(i) (ii)	338,720 -------------	13,541 -------------	5,834 -------------	11,878 -------------	39,579 -------------	409,552 -------------	-------------
15MARK BRETT FORMER BOARD MEMBER	(i) (ii)	------------- 540,963	-------------	------------- 4,014	------------- 82,423	------------- 40,611	------------- 668,011	-------------
16THOMAS OSTRANDER FORMER BOARD MEMBER	(i) (ii)	------------- 311,539	-------------	------------- 23,065	------------- 40,550	------------- 40,310	------------- 415,464	-------------
17DOUGLAS POFF DO FORMER BOARD MEMBER	(i) (ii)	185,241 -------------	65,600 -------------	2,830 -------------	7,579 -------------	30,443 -------------	291,693 -------------	-------------

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PAGE 1, PART I, LINE 1A	CERTAIN BOARD MEMBERS- AND EXECUTIVES' MICHIGAN ATHLETIC CLUB DUES ARE PAID BY THE ENTITY. THESE AMOUNTS ARE CONSIDERED TAXABLE COMPENSATION.
SCHEDULE J, PAGE 1, PART I, LINE 3	SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW CARSON HOSPITAL. SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION THAT INCLUDES A NUMBER OF NON-PROFIT ENTITIES. THE METHODS SELECTED FOR DETERMINING THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR ARE METHODS WHICH ARE BEING USED BY ALL SPARROW HEALTH SYSTEM RELATED ENTITIES.
SCHEDULE J, PAGE 1, PART I, LINE 4	GARY REETZ 0 31,738 0 PAULA REICHLE 0 46,140 0 MATTHEW J. THOMPSON 52,205 0 0 MARK BRETT 0 50,123 0
SCHEDULE J, PAGE 1, PART I, LINE 7	COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET.
SCHEDULE J, PART III	MARK BRETT, THOMAS OSTRANDER, AND DOUGLAS POFF ARE FORMER BOARD MEMBERS BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN POSITIONS OTHER THAN BOARD MEMBERS. THE FORMER BOARD MEMBERS ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO SPARROW CARSON HOSPITAL AS FORMER BOARD MEMBERS.

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) NANCY SEALS	FAMILY	80,773	EMPLOYEE		No
(2) JASSE AKIN	FAMILY	58,199	EMPLOYEE		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Return Reference	Explanation
FORM 990	ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART IV, QUESTION 4 - THE ORGANIZATION HAS MEMBERSHIPS IN VARIOUS 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	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, AND HOME HEALTH CARE, 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. FOR THE YEAR ENDED DECEMBER 31, 2018, SCCH PROVIDED OVER 2 MILLION IN UNCOMPENSATED CARE. THE ESTIMATED ANNUAL TOTAL LOCAL ECONOMIC IMPACT IS 30,000,000.
FORM 990, PAGE 2, PART III, LINE 4D	OTHER PROGRAM SERVICES INCLUDE THE OPERATION OF THE FOLLOWING FACILITIES: SPARROW MEDICAL GROUP (SMG) ASHLEY, SPARROW CARSON HOSPITAL, SMG GENERAL SURGERY, PHYSICAL REHABILITATION CENTER, SMG FOWLER, SMG GREENVILLE, HOSPITALISTS, SMG PEDIATRICS CARSON CITY, SMG STANTON, CARSON HOME CARE, SMG PAIN MANAGEMENT.
FORM 990, PAGE 6, PART VI, LINE 6	SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW CARSON HOSPITAL AND HAS 100% OWNERSHIP.
FORM 990, PAGE 6, PART VI, LINE 7A	SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT MEMBERS OF THE SPARROW CARSON HOSPITAL BOARD. THE PRESIDENT OF THE MEDICAL STAFF, WHICH IS A MEMBER OF THE GOVERNING BODY, IS ELECTED BY THE MEDICAL STAFF OF SPARROW CARSON HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7B	SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, AND REMOVE DIRECTORS OF SPARROW CARSON HOSPITAL BOARD. SPARROW HEALTH SYSTEM ALSO HAS THE AUTHORITY TO APPROVE DECISIONS OF THE SPARROW CARSON HOSPITAL BOARD WHEN IT IS DEEMED NECESSARY.
FORM 990, PAGE 6, PART VI, LINE 11B	COPIES OF THE 2018 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT COMPLETED ITS REVIEW OF FORM 990 COPIES WERE PROVIDED AT THE FALL 2019 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 INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING 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, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING 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 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VII	SPARROW HEALTH SYSTEM IS AN INTEGRATED NON-PROFIT ORGANIZATION AND IS THE PARENT CORPORATION OF SPARROW CARSON HOSPITAL AND OTHER RELATED ENTITIES. DENNIS SWAN WAS THE PRESIDENT & CHIEF EXECUTIVE OFFICER OF SPARROW HEALTH SYSTEM AND THEREBY SERVED AS THE PRINCIPAL OFFICER WITH ULTIMATE RESPONSIBILITY FOR IMPLEMENTING THE DECISIONS OF THE GOVERNING BODY OR SUPERVISING THE MANAGEMENT, ADMINISTRATION OR OPERATION OF ENTITIES WITHIN THE SYSTEM FOR THE MAJORITY OF THE TAX YEAR. PAULA REICHLE IS THE VICE PRESIDENT & CHIEF FINANCIAL OFFICER OF SPARROW HEALTH SYSTEM AND THEREBY HAS ULTIMATE RESPONSIBILITY FOR MANAGING THE FINANCIAL OPERATIONS OF THE SYSTEM AND THEREFORE IS THE SIGNATURE OFFICER OF THE HEALTH SYSTEM.
FORM 990, PART XI, LINE 9	WIP - ACTIVITIES 48,770 PY ADJUSTMENT 3,910 EXTRAORDINARY LOSS (ASSET IMPAIRMENT) -11,960,000 TOTAL -11,907,320

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SPARROW CARSON HOSPITAL

Employer identification number

38-1490180

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CARSON FOUNDATION INC 406 E ELM STREET CARSON CITY,MI48811 46-0877509	FUNDRAISE	MI	501C3	12A	CCH	Yes
(2)SPARROW HEALTH SYSTEM 1215 E MICHIGAN AVENUE LANSING,MI48912 38-2542859	PARENT	MI	501C3	12A	NA		No
(3)SPARROW COMMUNITY CARE 3315 E MICHIGAN AVENUE STE 4 LANSING,MI48912 38-2543305	HLTH CARE	MI	501C3	10	SHS	Yes
(4)PHYSICIANS HEALTH PLAN 1400 E MICHIGAN AVENUE LANSING,MI48912 38-2356288	INSURANCE	MI	501C4		SHS	Yes
(5)PHP MEDICARE 1400 E MICHIGAN AVENUE LANSING,MI48912 83-2766121	HMO	MI	501C4		PHP	Yes
(6)PHYSICIANS HEALTH NETWORK 1400 E MICHIGAN AVENUE LANSING,MI48912 38-2594856	HMO	MI	501C4		SHS	Yes
(7)SPARROW FOUNDATION 1215 E MICHIGAN AVENUE LANSING,MI48912 38-6100687	FUNRAISE	MI	501C3	12B	SHS	Yes
(8)SPARROW CLINTON HOSPITAL 805 S OAKLAND ST JOHNS,MI48879 38-1358172	HLTH CARE	MI	501C3	3	SHS	Yes
(9)SPARROW SPECIALTY HOSPITAL 1215 E MICH AVE 8W SPARROW TOWER LANSING,MI48912 14-1885340	LT CARE	MI	501C3	3	SHS	Yes
(10)SPARROW IONIA HOSPITAL 3565 S STATE RD IONIA,MI48846 38-3218134	HLTH CARE	MI	501C3	3	SHS	Yes
(11)SPARROW CLINICAL RESEARCH INSTITUTE 1200 E MICHIGAN AVENUE LANSING,MI48912 38-3075242	RESEARCH	MI	501C3	4	SHS	Yes
(12)EDWARD W SPARROW HOSPITAL 1215 E MICHIGAN AVENUE LANSING,MI48912 38-1360584	HLTH CARE	MI	501C3	3	SHS	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) SPARROW DEVELOPMENT INC 1215 E MICHIGAN AVENUE LANSING,MI48912 38-2595963	RENTAL	MI	N/A				Yes
(2) PHP INSURANCE COMPANY 1400 E MICHIGAN AVENUE LANSING,MI48912 20-5565219	INSURANCE	MI	N/A				Yes
(3) PHP SERVICE COMPANY 1400 E MICHIGAN AVENUE LANSING,MI48912 38-3344741	MED SRVCS	MI	N/A				Yes
(4) EAST LANSING ATHLETIC CLUB 2900 HANNAH BLVD LANSING,MI48823 38-2886420	HLTH CLUB	MI	N/A				Yes
(5) MAC RESTAURANT LLC 2900 HANNAH BLVD EAST LANSING,MI48823 20-5120690	RESTAURANT	MI	N/A				Yes
(6) CLINTON SERVICES CORPORATION 805 S OAKLAND ST JOHNS,MI48879 38-2494110	SERVICES	MI	N/A				Yes
(7) EAST LANSING HLTH ATH CLUB & HSP 1200 E MICHIGAN AVENUE STE 600 LANSING,MI48912 81-3131851	CONDO ASSO	MI	N/A				Yes

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) EDWARD W SPARROW HOSPITAL	P	508,548	COST
(2) CARSON FOUNDATION INC	C	40,169	COST

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF SPARROW CARSON HOSPITAL (SCCH) IS TO PROVIDE HIGH QUALITY & ACCESSIBLE HEALTH CARE SERVICES TO COMMUNITIES WE SERVE. SCCH PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	439
6	Total number of volunteers (estimate if necessary) .............	6	38
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	991

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	7,907	40,169
9	Program service revenue (Part VIII, line 2g) .........	46,882,761	44,533,585
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	388,460	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,075,570	2,445,429
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	49,354,698	47,019,183
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	32,969,927	30,792,334
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	27,062,031	23,116,552
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	60,031,958	53,908,886
19	Revenue less expenses. Subtract line 18 from line 12.......	-10,677,260	-6,889,703
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	53,593,075	37,620,945
21	Total liabilities (Part X, line 26).............	26,612,233	29,756,568
22	Net assets or fund balances. Subtract line 21 from line 20.....	26,980,842	7,864,377

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 38,089,715 including grants of $ ) (Revenue $ 34,263,125 )
	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, AND HOME HEALTH CARE, 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. FOR THE YEAR ENDED DECEMBER 31, 2018, SCCH PROVIDED OVER 2 MILLION IN UNCOMPENSATED CARE. THE ESTIMATED ANNUAL TOTAL LOCAL ECONOMIC IMPACT IS 30,000,000.

4b	(Code: ) (Expenses $ 3,205,231 including grants of $ ) (Revenue $ 3,123,702 )
	CARSON APOTHECARY SHOPPE IS A FULL-SERVICE RETAIL PHARMACY THAT OFFERS A SELECTION OF OVER-THE-COUNTER HEALTHCARE ITEMS AND MEDICATIONS. PHARMACIST PRESCRIPTION CONSULATION AND A FREE HEALTH INFORMATION STATION WITH TAKE- HOME BROCHURES ARE AVAILABLE. THE CARSON APOTHECARY SHOPPE ALSO OFFERS A SELECTION OF NEWBORN GIFTS, SEASONAL ITEMS, CARDS AND SNACKS. IT IS OPEN MONDAY THROUGH FRIDAY AND SATURDAY MORNING.

4c	(Code: ) (Expenses $ 1,483,982 including grants of $ ) (Revenue $ 2,178,007 )
	SMG ORTHOPEDIC SURGERY CLINIC PROVIDES CARE FOR FRACTURES, HAND SURGERY, KNEE ARTHROSCOPY, SHOULDER ARTHROSCOPY, SHOULDER INJURIES, SPORTS INJURIES, AND TOTAL HIP, KNEE, OR SHOULDER REPLACEMENT.

	(Code: ) (Expenses $ 6,682,498 including grants of $ ) (Revenue $ 4,968,752 )
	OTHER PROGRAM SERVICES INCLUDE THE OPERATION OF THE FOLLOWING FACILITIES: SPARROW MEDICAL GROUP (SMG) ASHLEY, SPARROW CARSON HOSPITAL, SMG GENERAL SURGERY, PHYSICAL REHABILITATION CENTER, SMG FOWLER, SMG GREENVILLE, HOSPITALISTS, SMG PEDIATRICS CARSON CITY, SMG STANTON, CARSON HOME CARE, SMG PAIN MANAGEMENT.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 6,682,498 including grants of $ ) (Revenue $ 4,968,752 )
4e	Total program service expenses49,461,426

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) BARBARA MCQUILLAN........................................................................ CNO-PART YEA	40.00 .......................	X			84,502	0	20,490
(19) PARUTAPPA BHIMALLI MD........................................................................ PHYSICIAN	40.00 .......................		X		507,116	0	58,469
(20) MICHAEL RACINE MD........................................................................ PHYSICIAN	40.00 .......................		X		412,840	0	53,269
(21) MICHELLE BECHER........................................................................ PHYSICIAN	40.00 .......................		X		382,922	0	53,365
(22) ALBERTO BETANCOURT........................................................................ PHYISICIAN	40.00 .......................		X		372,551	0	28,516
(23) JOSE MALDONADO MD........................................................................ PHYSICIAN	40.00 .......................		X		358,095	0	51,457
(24) MARK BRETT........................................................................ FORMER BOARD	0.00 .......................40.00			X	0	544,977	123,034
(25) THOMAS OSTRANDER........................................................................ FORMER BOARD	0.00 .......................40.00			X	0	334,604	80,860
(26) DOUGLAS POFF DO........................................................................ FORMER BOARD	40.00 .......................			X	253,671	0	38,022

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,420,882	3,389,600	1,146,872

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	40,169
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		40,169

		Business Code
2a	NET PATIENT SERVICE REVENUE	621300	44,533,585	44,533,585
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		44,533,585

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		52,070
b	Less: rental expenses
c	Rental income or (loss)		52,070
d	Net rental income or (loss)......			52,070		52,070
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CONTRACTED PHARMACY 340B REV		722210	1,553,581	1,553,581
b	COFFEE SHOP, CAFETERIA, OTHER		900099	839,778		839,778
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,393,359
12	Total revenue. See Instructions......			47,019,183	46,087,166	891,848

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	562,409		562,409
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	23,049,313	21,886,685	1,162,628
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,178,227		1,178,227
9	Other employee benefits .......	4,457,134	3,737,096	720,038
10	Payroll taxes ...........	1,545,251	1,391,027	154,224
11	Fees for services (non-employees):
a	Management ......	215,167	215,167
b	Legal .........
c	Accounting ...........	38,575		38,575
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	291,413	94,391	197,022
12	Advertising and promotion ....	93,935	93,935
13	Office expenses .......	2,723,422	2,604,204	119,218
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1,510,743	1,222,842	287,901
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	174,448	147,230	27,218
20	Interest ...........	168,598	168,598
21	Payments to affiliates .......	4,083,502	4,083,502
22	Depreciation, depletion, and amortization ..	3,760,094	3,760,094
23	Insurance ...	603,678	603,678
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS & PHARMACEUTICALS	5,776,956	5,776,956
b	QUALITY ASSURANCE TAXES	1,357,197	1,357,197
c	IMPLANTS	659,491	659,491
d	ORTHO JOINT REPLACEMENT	116,660	116,660
e	All other expenses	1,542,673	1,542,673
25	Total functional expenses. Add lines 1 through 24e	53,908,886	49,461,426	4,447,460	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			2,231	1	1,897
2	Savings and temporary cash investments .........			990,835	2	670,654
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			4,945,806	4	4,991,354
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			1,403,928	8	1,407,909
9	Prepaid expenses and deferred charges ......			264,365	9	259,939
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	33,031,107
b	Less: accumulated depreciation	10b	12,195,162	35,900,979	10c	20,835,945
11	Investments—publicly traded securities .			7,343,490	11	7,006,421
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,741,441	15	2,446,826
16	Total assets. Add lines 1 through 15 (must equal line 34)...			53,593,075	16	37,620,945

17	Accounts payable and accrued expenses .....	23,894,569	17	27,008,110
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	5,010	20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	2,387,654	23	2,308,458
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	325,000	25	440,000
26	Total liabilities. Add lines 17 through 25..	26,612,233	26	29,756,568

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	26,980,842	27	7,864,377
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	26,980,842	33	7,864,377
34	Total liabilities and net assets/fund balances ........	53,593,075	34	37,620,945