SPARROW CARSON HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: SPARROW CARSON HOSPITAL (EIN 38-1490180)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201333199349302618
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T09:36:10-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE HORWATH LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	70 West Madison Street	AddressLine1
Address Line2	Suite 700	AddressLine2
City	Chicago	City
State	IL	State
ZIP Code	606024903	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	381490180	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CARSON CITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CARS	NameControl
Phone	9895843971	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	406 E Elm Street	AddressLine1
Address Line2	PO Box 879	AddressLine2
City	Carson City	City
State	MI	State
ZIP Code	48811	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DUANE C MILLER	Name
Title	CFO	Title
Date Signed	2013-04-11	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Geralyn Hurd	Name
PTIN	P00933422	PTIN
Phone	3128997000	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MATTHEW THOMPSON	BusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	406 E Elm Street	AddressLine1
City	Carson City	City
State	MI	State
ZIP Code	48811	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	60626534	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CARSONHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1938	YearFormation
State Legal Domicile	MI	StateLegalDomicile
Activity Or Mission Description	THE MISSION OF CARSON CITY HOSPITAL (CCH) IS TO PROVIDE HIGH QUALITY & ACCESSIBLE HEALTH CARE SERVICES TO COMMUNITIES WE SERVE. IN CONJUNCTION, CCH PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	729	TotalNbrEmployees
Total Nbr Volunteers	130	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	179222	ContributionsGrantsPriorYear
Contributions Grants Current Year	101927	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	59862979	ProgramServiceRevenuePriorYear
Program Service Revenue CY	58936320	ProgramServiceRevenueCY
Investment Income Prior Year	164770	InvestmentIncomePriorYear
Investment Income Current Year	416201	InvestmentIncomeCurrentYear
Other Revenue Prior Year	602659	OtherRevenuePriorYear
Other Revenue Current Year	712517	OtherRevenueCurrentYear
Total Revenue Prior Year	60809630	TotalRevenuePriorYear
Total Revenue Current Year	60166965	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	19979	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	32574506	SalariesEtcPriorYear
Salaries Etc Current Year	35461383	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	14370	TotalFundrsngExpCurrentYear
Other Expense Prior Year	27476512	OtherExpensePriorYear
Other Expenses Current Year	25339837	OtherExpensesCurrentYear
Total Expenses Prior Year	60070997	TotalExpensesPriorYear
Total Expenses Current Year	60801220	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	738633	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-634255	RevenuesLessExpensesCY
Total Assets BOY	46428348	TotalAssetsBOY
Total Assets EOY	45594758	TotalAssetsEOY
Total Liabilities BOY	23228049	TotalLiabilitiesBOY
Total Liabilities EOY	25177381	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	23200299	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	20417377	NetAssetsOrFundBalancesEOY
Mission Description	THE MISSION OF CARSON CITY HOSPITAL (CCH) IS TO PROVIDE HIGH QUALITY AND ACCESSIBLE HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE AND TO PROVIDE CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	36526667	Expense
Revenue	50203892	Revenue
Description	CCH IS A 77-BED, ACUTE CARE HOSPITAL LOCATED IN CENTRAL MICHIGAN. IT IS THE OLDEST OSTEOPATHIC HOSPITAL IN MICHIGAN, FOUNDED IN 1936 BY EMMETT BINKERT, D.O. SINCE THIS TIME, CCH HAS BEEN COMMITTED TO SERVING THE RESIDENTS IN A FOUR-COUNTY AREA. CCH CURRENTLY OPERATES A SHORT-TERM, ACUTE-CARE FACILITY AND SEVERAL SATELLITE CLINICS OFFERING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES, PSYCHIATRIC SERVICES, PHYSICIAN SERVICES, AND HOME HEALTH CARE, PRIMARILY TO PATIENTS IN THE CARSON CITY, MICHIGAN AREA, INCLUDING GRATIOT, MONTCALM, CLINTON, AND IONIA COUNTIES. CCH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE CCH 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, CCH 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, CCH ALSO PROVIDES NUMEROUS OTHER SERVICES, WHICH BENEFIT THE COMMUNITY AND ARE GENERALLY PERFORMED AT NO CHARGE AND 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, 2012, CCH PROVIDED OVER $2 MILLION IN UNCOMPENSATED CARE. THE ESTIMATED ANNUAL TOTAL LOCAL ECONOMIC IMPACT IS $30,000,000.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1670043	Expense
Revenue	1637982	Revenue
Description	ITHACA FAMILY CARE CENTER (IFCC) IS AN OFFICE WITH 2 PHYSICIANS, 1 NURSE PRACTITIONER, AND 1 PHYSICIAN ASSISTANT THAT FOCUSES ON FAMILY PRACTICE FOR GRATIOT COUNTY. IFCC PROVIDES OUTPATIENT SERVICES SUCH AS AUDIOMETRY, BLOOD PRESSURE CHECK, EAR EXAMINATION, EKG, EXCISION, FOREIGN BODY REMOVAL, GYNECOLOGICAL EXAMINATIONS, HEALTH EDUCATION, HEMOCCULT, IMMUNIZATION, LACERATION, OFFICE VISITS, OSTEOPATHIC MANIPULATIVE THERAPY, PATIENT COUNSELING, PHYSICAL EXAMINATIONS AND PREMARITAL COUNSELING. THEY ALSO PROVIDE LABORATORY SERVICES SUCH AS BLOOD SUGAR, HEMOGLOBIN, PREGNANCY TESTING, UA (DIPSTICK) AND WET PREP.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1471162	Expense
Revenue	1325873	Revenue
Description	CARSON FAMILY CARE CENTER (CFCC) IS AN OFFICE WITH 2 PHYSICIANS AND 1 NURSE PRACTITIONER THAT FOCUSES ON FAMILY PRACTICE FOR MONTCALM COUNTY. CFCC PROVIDES OUTPATIENT SERVICES SUCH AS ASTHMA SERVICES, AUDIOMETRY, BLOOD PRESSURE CHECKS, DISABILITY/IMPAIRMENT EVALUATIONS, DRUG AND ALCOHOL SCREENING, EAR EXAMINATION, EKG, EMPLOYEE SCREENING, EXCISION, FOREIGN BODY REMOVAL, GYNECOLOGICAL EXAMINATION, HEALTH EDUCATION, IMMUNIZATION, IMMUNOTHERAPY, INJURY MANAGEMENT WORK RELATED INJURIES, LACERATION, LASER COSMETICS, OFFICE VISITS, OSTEPATHIC MANIPULATIVE THERAPY, PATIENT COUNSELING, PHYSICAL EXAMINATIONS, PRE-EMPLOYMENT PHYSICALS, PREMARITAL COUNSELING, SAFETY PROGRAMS AND WORK SITE VISITS. THEY ALSO PROVIDE LABORATORY SERVICES SUCH AS BLOOD SUGAR, HEMOCCULT, HEMOGLOBIN, PREGNANCY TESTING, UA (DIPSTICK) AND WET PREP.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	6076484	Expense
Revenue	5768573	Revenue
Description	OTHER PROGRAM SERVICES INCLUDE THE OPERATION OF THE FOLLOWING FACILITIES: ASHLEY FAMILY CARE CENTER CARSON BEHAVIORAL CARE CENTER CARSON CITY HOSPITAL ORTHOPEDICS AND GENERAL SURGERY PHYSICAL REHABILITATION CENTER FOWLER FAMILY CARE CENTER GREENVILLE FAMILY CARE CENTER HOSPITALISTS LYONS FAMILY CARE CENTER PEDIATRIC AND ADOLESCENT SPECIALISTS STANTON FAMILY CARE CENTER CARSON HOME CARE CARSON PAIN MANAGEMENT	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	6076484	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	5768573	TotalOfOtherProgramServiceRev
Total Program Service Expense	45744356	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	170	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	729	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	true	LocalChapters
Policies Reference Chapters	true	PoliciesReferenceChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Duane Miller	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	9895843971	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	406 E Elm Street	AddressLine1
City	Carson City	City
State	MI	State
ZIP Code	48811	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
BRENT WILSON
CHAIR	2.00	X	X	0	0	0
HAROLD HOUSE
VICE CHAIR	2.00	X	X	0	0	0
MATTHEW J THOMPSON
PRESIDENT/CEO	40.00	X	X	232493	0	14421
ROBERT SEALS DO
SECRETARY/TREASURER, MEDICAL DIRECTOR	40.00	X	X	316669	0	13142
CINDA KOSLOSKI
BOARD MEMBER (1 MONTH - DEC, SEE STATEMENT)	2.00	X		0	0	0
DEBBY CASSADY
BOARD MEMBER (7 MONTHS JAN-JULY)	2.00	X		0	0	0
DOUGLAS POFF DO
BOARD MEMBER/PHYSICIAN	40.00	X		192626	0	14202
GARY REETZ
BOARD MEMBER (SEE STATEMENT)	2.00	X		0	0	0
JARED MERCHANT
BOARD MEMBER (4 MONTHS SEP-DEC)	2.00	X		0	0	0
MARK BRETT
BOARD MEMBER	2.00	X		0	0	0
REX A RIMMEL DO
BOARD MEMBER	2.00	X		0	0	0
RODERICK COY
BOARD MEMBER	2.00	X		0	0	0
TOM MACDONALD
BOARD MEMBER	2.00	X		0	0	0
TOM OSTRANDER
BOARD MEMBER	2.00	X		0	0	0
DUANE C MILLER
SENIOR VP FINANCE/CFO	40.00		X	150658	0	11670
NANCY A WEAVER
VP NURSING/CNO	40.00		X	150939	0	10006
NATALIE W BUSLEPP
DIRECTOR OF MEDICAL SERVICES GROUP	40.00		X	151895	0	11007
RICHARD D TERRY
VP/CIO	40.00		X	101806	0	6404
CHRISTOPHER E HERALD MD
ER DIRECTOR	40.00			311931	0	15069	X
DAVID J FREESTONE MD
PHYSICIAN/CHIEF OF STAFF	40.00			302556	0	14400	X
ADAM Z COTE
PHYSICIAN	40.00			566664	0	16197		X
JOSEPH B WHITE
PHYSICIAN	40.00			604033	0	7204		X
MICHAEL H MULLINS
PHYSICIAN	40.00			359727	0	7773		X
PARUTAPPA R BHIMALLI
PHYSICIAN	40.00			490994	0	16725		X
RAYMOND P ALLARD
PHYSICIAN	40.00			499314	0	8786		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4432305	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	167006	TotalOtherCompensation
Number Individuals GT100 K	43	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
PHARMACY SYSTEMS INC
PO BOX 71-0716	COLUMBUS	OH	43271	PHARMACY CONSULTING SERVICES	223700
ROBERT HALF INTERNATIONAL
12400 COLLECTIONS CENTER DR	CHICAGO	IL	60693	ACCOUNTING SERVICES/CONSULTING	183773
QUEUE ADVERTISING
410 S CEDAR STE F	LANSING	MI	48912	ADVERTISING SERVICES	170032
LIFE CARE SLEEP AND HEALTH CENTER LLC
7200 W SAGINAW HWY SUITE 1	LANSING	MI	48917	SLEEP STUDY CONSULTING	154950
INNOVATIVE PRACTICE CONCEPTS LLC
2350 OAK INDUSTRIAL DR NE STE A	GRAND RAPIDS	MI	49505	MEDICAL PRACTICE CONSULTING	125707

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	7	NumberOfContractorsGT100K
Government Grants	35550	GovernmentGrants
All Other Contributions	66377	AllOtherContributions
Total Contributions	101927	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621300	60483245	60483245
MEDICARE/MEDICAID "HITECH" REVENUE	900099	1348670	1348670
BAD DEBT EXPENSE		-2895595	-2895595
		0
		0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	58936320	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	408646	TotalRevenueColumn
Exclusion	$408,646	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	507597	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	458224	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	49373	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	49373	TotalRevenueColumn
Exclusion	$49,373	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	8900	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	1345	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	7555	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	7555	TotalRevenueColumn
Exclusion	$7,555	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
CAFETERIA/COFFEE SHOP/VENDING	722219	308449	$308,449
MISCELLANEOUS	900099	354695	$354,695
		0

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	663144	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	60166965	TotalRevenueColumn
Related Or Exempt Function Income	58936320	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,128,718	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2160630	Total
Program Services	1066894	ProgramServices
Management And General	1093736	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	27205076	Total
Program Services	23505530	ProgramServices
Management And General	3699546	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1444077	Total
Program Services	481906	ProgramServices
Management And General	962171	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2713924	Total
Program Services	523007	ProgramServices
Management And General	2190917	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1937676	Total
Program Services	1453547	ProgramServices
Management And General	484129	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	277846	Total
Management And General	277846	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	131294	Total
Management And General	127726	ManagementAndGeneral
Fundraising	3568	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	309882	Total
Management And General	309882	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	39981	Total
Management And General	39981	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1158631	Total
Program Services	5718	ProgramServices
Management And General	1145617	ManagementAndGeneral
Fundraising	7296	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	3799064	Total
Program Services	2701528	ProgramServices
Management And General	1094054	ManagementAndGeneral
Fundraising	3482	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1379759	Total
Program Services	250466	ProgramServices
Management And General	1129293	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3511189	Total
Program Services	2950844	ProgramServices
Management And General	560345	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	174011	Total
Program Services	97802	ProgramServices
Management And General	76185	ManagementAndGeneral
Fundraising	24	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	354650	Total
Program Services	354650	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1829065	Total
Program Services	1829065	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	823743	Total
Management And General	823743	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
DIRECT PATIENT CARE SUPPLIES & EXPENSES	9081688	9081688
RECRUITING	347895		347895
PROVIDER/OTHER TAXES	2121139	1441711	679428

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	60801220	Total
Program Services	45744356	ProgramServices
Management And General	15042494	ManagementAndGeneral
Fundraising	14370	Fundraising

Total Joint Costs TotalJointCosts

Field	Value	IRS element (for citing)
Total	0	Total

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4633	BOY
EOY	4654	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3996424	BOY
EOY	3657966	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	28207	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	10007350	BOY
EOY	8979500	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	43588	BOY
EOY	65356	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	987209	BOY
EOY	1357876	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2136643	BOY
EOY	2295049	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	46576330	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	24339968	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	23307798	BOY
EOY	22236362	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	5065752	BOY
EOY	5511066	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	239804	BOY
EOY	239805	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	610940	BOY
EOY	1247124	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	46428348	BOY
EOY	45594758	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	6029100	BOY
EOY	7468462	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	15147534	BOY
EOY	14390157	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1318003	BOY
EOY	2140214	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	22510	BOY
EOY	20010	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	710902	BOY
EOY	1158538	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	23228049	BOY
EOY	25177381	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	22936749	BOY
EOY	20180658	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	263550	BOY
EOY	236719	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	23200299	BOY
EOY	20417377	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	46428348	BOY
EOY	45594758	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-634255	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	156525	ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment	-1788410	ReconcilationPriorAdjustment
Reconcilation Other Changes	-516782	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$3,830	OtherActivitiesAmount
Total Lobbying Expenditures IIB	3830	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Description of the activities reported on Lines 1a through 1i	Identifier
Return Reference	Schedule C, Part II-B, Line 1	ReturnReference
Explanation	THE ORGANIZATION INDIRECTLY INFLUENCED LEGISLATION THOUGH ITS ANNUAL DUES PAID TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION; 16.32% OF DUES PAID WERE USED FOR SPECIFIC LOBBYING PURPOSES.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	731643	OtherCostOrOtherBasis
Book Value	731643	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	31425804	OtherCostOrOtherBasis
Depreciation	14141512	Depreciation
Book Value	17284292	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1512074	OtherCostOrOtherBasis
Depreciation	594823	Depreciation
Book Value	917251	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	12725441	OtherCostOrOtherBasis
Depreciation	9603633	Depreciation
Book Value	3121808	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	181368	OtherCostOrOtherBasis
Book Value	181368	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	22236362	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DEFINED BENEFIT PENSION LIABILITY	Description
Amount	$1,158,538	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	1158538	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	FIN 48 (ASC 740) footnote	Identifier
Return Reference	Schedule D, Part X, Line 2	ReturnReference
Explanation	THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPALS GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2009.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2267877	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	2267877	NetCommunityBenefitExpense
Percent Of Total Expense	0.03730	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10916508	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8905959	DirectOffsettingRevenue
Net Community Benefit Expense	2010549	NetCommunityBenefitExpense
Percent Of Total Expense	0.03310	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2327642	TotalCommunityBenefitExpense
Direct Offsetting Revenue	613133	DirectOffsettingRevenue
Net Community Benefit Expense	1714509	NetCommunityBenefitExpense
Percent Of Total Expense	0.02820	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	15512027	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9519092	DirectOffsettingRevenue
Net Community Benefit Expense	5992935	NetCommunityBenefitExpense
Percent Of Total Expense	0.09860	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3214512	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	3214512	NetCommunityBenefitExpense
Percent Of Total Expense	0.05290	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	108179	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22011	DirectOffsettingRevenue
Net Community Benefit Expense	86168	NetCommunityBenefitExpense
Percent Of Total Expense	0.00140	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5893518	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2786519	DirectOffsettingRevenue
Net Community Benefit Expense	3106999	NetCommunityBenefitExpense
Percent Of Total Expense	0.05110	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17721	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	17721	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	9233930	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2808530	DirectOffsettingRevenue
Net Community Benefit Expense	6425400	NetCommunityBenefitExpense
Percent Of Total Expense	0.10570	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	24745957	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12327622	DirectOffsettingRevenue
Net Community Benefit Expense	12418335	NetCommunityBenefitExpense
Percent Of Total Expense	0.20430	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$2,895,595	BadDebtExpenseAmount
Amount Attributable To	75285	AmountAttributableTo
Amount Reimbursed By Medicare	10927919	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	12309911	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-1381992	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CARSON CITY HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	406 E ELM STREET	AddressLine1
City	CARSON CITY	City
State	MI	State
ZIP Code	48811	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours
Er Other	X	ErOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CARSON CITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
Explains Basis	false	ExplainsBasis
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	false	IncludesPublicityMeasures
Actions On Nonpayment	true	ActionsOnNonpayment
Permit Lawsuit	X	PermitLawsuit
Permit Other Actions	X	PermitOtherActions
Collection Activities	false	CollectionActivities
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	14	NumberOfOtherFacilities

Other Facilities OtherFacilities (14 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
ITHACA FAMILY CARE CENTER
114 N MAIN ST	ITHACA	MI	48847	GENERAL MEDICAL OUTPATIENT CLINIC
CARSON FAMILY CARE CENTER
102 S THIRD ST STE 100 BOX 277	CARSON CITY	MI	48811	GENERAL MEDICAL OUTPATIENT CLINIC
PHYSICAL REHABILITATION CARE CENTER
602 E ELM STREET	CARSON CITY	MI	48811	OUTPATIENT REHABILITATION CLINIC
CARSON HOME CARE
406 E ELM ST	CARSON CITY	MI	48811	HOME HEALTH CARE
GREENVILLE FAMILY CARE CENTER
1014 E WASHINGTON	GREENVILLE	MI	48838	GENERAL MEDICAL OUTPATIENT CLINIC
PEDIATRIC & ADOLESCENT SPECIALISTS
245 S SECOND ST BOX 847	CARSON CITY	MI	48811	GENERAL MEDICAL OUTPATIENT CLINIC
STANTON FAMILY CARE CENTER
545 N STATE ST BOX 638	STANTON	MI	48888	GENERAL MEDICAL OUTPATIENT CLINIC
ASHLEY FAMILY CARE CENTER
320 S STERLING ST BOX 96	ASHLEY	MI	48806	GENERAL MEDICAL OUTPATIENT CLINIC
CARSON PAIN MANAGEMENT
102 S THIRD STREET SUITE 300	CARSON CITY	MI	48811	OUTPATIENT PAIN MANAGEMENT OFFICE
CARSON CITY HOSPITAL ORTHOPEDICS AND GENERAL SURGERY
102 S THIRD ST STE 400 BOX 326	CARSON CITY	MI	48811	GENERAL MEDICAL/SURGICAL OUTPATIENT CLINIC
HOSPITALISTS
406 E ELM ST	CARSON CITY	MI	48811	GENERAL MEDICAL INPATIENT CLINIC
CARSON BEHAVIORAL HEALTH CENTER
102 S THIRD ST STE 500 BOX 417	CARSON CITY	MI	48811	BEHAVIORAL HEALTH CLINIC
FOWLER FAMILY CARE CENTER
11017 W THIRD ST BOX 19	FOWLER	MI	48835	GENERAL MEDICAL OUTPATIENT CLINIC
LYONS FAMILY CARE CENTER
505 E BRIDGE ST BOX 186	LYONS	MI	48851	GENERAL MEDICAL OUTPATIENT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	THE DEFINITION OF A COMMUNITY BENEFIT IS A SERVICE OR PROGRAM THAT THE HOSPITAL PROVIDES TO PROMOTE HEALTH AND HEALING AS A RESPONSE TO COMMUNITY NEEDS. COMMUNITY BENEFITS USUALLY GENERATE A LOW OR NEGATIVE FINANCIAL RETURN, RESPOND TO PUBLIC HEALTH NEEDS, INVOLVE EDUATION 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.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	0
Subsidized Health Services	Schedule H, Part I, Line 7g	THE COMMUNITY BENEFITS REPORT TAKES THE WHOLE HOSPITAL, WHICH ALSO TAKES THE MEDICAL SERVICES GROUP PHYSICIAN CLINICS INTO CONSIDERATION. SOME ITEMS CAN ONLY BE DONE IN THE HOSPITAL WHILE MANY OTHERS CAN BE DONE IN A PHYSICIAN CLINIC SETTING. THE $8.7 MILLION IN REVENUE THAT IS BROUGHT IN FROM THE PHYSICIAN CLINIC SETTING INCLUDES BLOOD PRESSURE CHECKS, CHILD IMMUNIZATIONS, AND CHOLESTEROL TESTING, AS WELL AS MANY OTHER PREVENTATIVE SERVICES IN LOW POPULATION, RURAL COMMUNITIES.
Bad debt expense - methodology used to estimate amount	Schedule H, Part III, Line 2	AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
Bad debt expense - methodology used to estimate amount as community benefit	Schedule H, Part III, Line 3	THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY REPORTED IN PART III, LINE 3 IS DETERMINED BY USING A PERCENTAGE (2.6%) OF THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE AT COST. THIS PERCENTAGE IS DETERMINED BY ANALYZING THE HOSPITAL'S WRITE-OFFS COMPARED TO ITS TOTAL GROSS REVENUE.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	SEE NOTE 1, PAGE 8 IN THE ATTACHED FINANCIAL STATEMENTS.
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	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. ANY SHORTFALLS THAT RESULT FROM MEDICARE ALLOWABLE COSTS EXCEEDING MEDICARE REVENUE CAN BE CONSIDERED A COMMUNITY BENEFIT IF THE ACTIVITY IS SOMETHING THAT CARSON CITY HOSPITAL IS DOING TO CREATE THE AWARENESS AND WELL-BEING OF THE HOSPITAL COMMUNITY.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	CARSON CITY HOSPITAL INITIATES COLLECTION AT THE POINT OF SERVICE THROUGH THE PATIENT ACCESS DEPARTMENT. PATIENTS ARE ADVISED OF THEIR CO-PAY AND DEDUCTIBLE AND ASKED FOR A DEPOSIT ON THESE SELF-PAY CONTRIBUTIONS. PATIENTS WHO DO NOT HAVE INSURANCE ARE ADVISED OF ESTIMATED COST, AND ASSISTANCE PROGRAMS ARE OFFERED ALONG WITH CONTACT INFORMATION TO OBTAIN FURTHER INFORMATION. THE PATIENT'S BILL IS CHARGED, CODED, AND PROCESSED WITH THE APPROPRIATE PAYORS, IF APPLICABLE, AND AT THE POINT ALL THIRD PARTY PAYORS HAVE MADE PAYMENT, THE REMAINING BALANCE IS BILLED ON A STATEMENT TO THE PATIENT. AT THE POINT THAT THE PATIENT RECEIVES THE STATEMENT, THEY MAY CHOOSE TO MAKE PAYMENT ARRANGEMENTS THROUGH A PAYMENT PLAN, OR MAY CHOOSE TO APPLY FOR ASSISTANCE. THE PATIENT WHO DOES NOT MAKE PAYMENT ARRANGEMENTS OR DOES NOT APPLY FOR ASSISTANCE, WILL RECEIVE THREE STATEMENTS OVER A 90-DAY PERIOD. IF NO RESOLUTION IS ACHIEVED THE ACCOUNT WILL BE REFERRED TO AN OUTSIDE AGENCY FOR COLLECTION. THE PATIENT HAS 60 DAYS AT THE AGENCY BEFORE THEIR ACCOUNT IS RECORDED AS BAD DEBT. THE PATIENT STILL HAS THE OPTION OF APPLYING FOR ASSISTANCE OR MAKING PAYMENT ARRANGEMENTS WITH THE AGENCY.
FINANCIAL ASSISTANCE POLICY: BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS	SCHEDULE H, PART V, SECTION B, LINE 11	AS SPECIFICALLY OUTLINED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL USES THE FOLLOWING FACTORS IN DETERMINING THE AMOUNTS CHARGED TO PATIENTS: - INCOME LEVEL - ASSET LEVEL - EXEMPT HOUSEHOLD ASSETS USING FEDERAL POVERTY INCOME GUIDELINES - FAMILY ASSETS - FAMILY EXPENSES AND OBLIGATIONS - MEDICAL INDIGENCY - INSURANCE STATUS - UNINSURED DISCOUNT - MEDICAID/MEDICARE
FINANCIAL ASSISTANCE POLICY: MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED	SCHEDULE H, PART V, SECTION B, LINE 13	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.
Other collection actions permitted	Schedule H, Part V Section B, Line 16e	(1) CARSON CITY HOSPITAL - IF AN ACCOUNT IS DELINQUENT BY 120 DAYS, AND THERE HAS BEEN NO PLAN FOR PAYMENT MADE OR FOLLOWED, THE ACCOUNT WILL BE CONSIDERED FOR FURTHER ACTION WHICH MAY INCLUDE: AN OUTSIDE COLLECTION AGENCY, SMALL CLAIMS COURT, OR OTHER ACTION. ALL REASONABLE EFFORTS MUST BE MADE BEFORE SENDING AN ACCOUNT TO A COLLECTION AGENCY, AND NO ACCOUNT SHALL BE SENT TO AN OUTSIDE COLLECTION AGENCY WITHOUT APPROVAL FROM AN AUTHORIZED ASSOCIATE OR OTHER APPROVED INDIVIDUAL. IF AN ACCOUNT PLACED IN A COLLECTION AGENCY HAS BEEN DETERMINED TO NEED LEGAL ACTION TO COLLECT THE BALANCE, THE ACCOUNT MUST BE REVIEWED BY AN ADMINISTRATOR BEFORE SUIT CAN BE FILED.;
Means used to determine amounts billed	Schedule H, Part V Section B, Line 20d	(1) CARSON CITY HOSPITAL - DURING 2011, THE HOSPITAL FACILITY USED THE HIGHEST COMMERCIAL RATE WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. DURING 2012, THE HOSPITAL FACILITY HAS CHANGED ITS PRACTICE AND USES THE AVERAGE OF THE THREE HIGHEST COMMERCIAL RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.;
Needs assessment.	Schedule H, Part VI, Line 2	CARSON CITY 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.
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	CARSON CITY HOSPITAL OFFERS SEVERAL OPTIONS FOR ASSISTING PATIENTS WITH THEIR BILLS; THIS ASSISTANCE INFORMATION IS OFFERED AT THE TIME OF REGISTRATION, THROUGH PHONE CONTACT, AND IS ADVISED ON THE PATIENTS STATEMENTS. A TOLL FREE NUMBER IS PROVIDED FOR PATIENTS TO CALL AND INQUIRE ABOUT ASSISTANCE IF PERSONAL CONTACT WAS NOT AVAILABLE AT THE TIME THE PATIENT RECEIVED SERVICES. CARSON CITY HOSPITAL, THROUGH A PARTNERSHIP WITH MONTCALM COUNTY DEPARTMENT OF HUMAN SERVICES, PROVIDES DIRECT ON-SITE ACCESS TO A MARA (MEDICAID ASSISTANCE REVIEW AGREEMENT) WORKER (DHS TRAINED STAFF MEMBER) WHO ASSISTS THE PATIENT WITH THE APPLICATION PROCESS FOR STATE OR COUNTY PROGRAMS, AND IF THE PATIENT DOES NOT MEET THE REQUIREMENTS FOR THESE TYPES OF ASSISTANCE, PROVIDES THE PATIENT WITH THE CHARITY CARE APPLICATION. THIS APPLICATION IS PROCESSED BY THE HOSPITAL BILLING DEPARTMENT AND IF APPROVED FOR ASSISTANCE PROVIDES CHARITY CARE AT 200% OF THE FEDERAL POVERTY GUIDELINES. THE ASSISTANCE PROGRAM INFORMATION FOR PATIENTS IS HANDED OUT AT THEIR TIME OF SERVICE BY THE RESPECTED DEPARTMENTS (RADIOLOGY, LABORATORY, PRE-ADMISSION TESTING, ETC). A MARA (MEDICAID ASSISTANCE REVIEW AGREEMENT) WORKER IS ON-SITE FOR INDIVIDUALS THAT DO SEEK ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY IS ALSO POSTED ON THE HOSPITAL'S WEBSITE, IS AVAILABLE TO ANYONE UPON REQUEST, AND IS POSTED IN THE EMERGENCY/WAITING ROOMS AND ADMISSIONS OFFICE.
Community information.	Schedule H, Part VI, Line 4	CARSON CITY HOSPITAL (CCH) IS A 77-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 CCH HAS BEEN COMMITTED TO SERVING THE RESIDENTS OF COMMUNITIES IN A FOUR-COUNTY AREA. THE HOSPITALS GOVERNING BODY CONSISTS PRIMARILY OF VOLUNTEER MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. IN THE FALL OF 1996, 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 CARSON CITY 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 21,750 HOUSEHOLDS WITH AN AVERAGE HOUSEHOLD SIZE OF 2.7 PEOPLE. THE AVERAGE INCOME PER HOUSEHOLD IS $47,355 WHILE 13.75% 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 GRATIOT MEDICAL CENTER. IN ADDITION TO ACUTE HOSPITAL CARE, CCH PROVIDES A VARIETY OF ADVANCED SERVICES, RANGING FROM AN INTENSIVE/CORONARY CARE UNIT TO A BEHAVIORAL HEALTH UNIT AND MULTIPLE OUTPATIENT SERVICES. CCH 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. ELIGIBILITY FOR ANNUAL MEDICARE INCENTIVE PAYMENTS IS DEPENDENT ON PROVIDERS DEMONSTRATING MEANINGFUL USE OF EHR TECHNOLOGY IN EACH PERIOD OVER A FOUR-YEAR PERIOD. INITIAL MEDICAID INCENTIVE PAYMENTS ARE AVAILABLE TO PROVIDERS THAT ADOPT, IMPLEMENT, OR UPGRADE CERTIFIED EHR TECHNOLOGY, BUT PROVIDERS MUST DEMONSTRATE MEANINGFUL USE OF SUCH TECHNOLOGY IN SUBSEQUENT YEARS TO QUALIFY FOR ADDITIONAL INCENTIVE PAYMENTS. DURING 2012, CARSON CITY 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.
Promotion of community health	Schedule H, Part VI, Line 5	CARSON CITY 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 SCHOOLCHILDREN, 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. CARSON CITY 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 CARSON CITY HOSPITAL THROUGH A PROCESS TO TREAT AND PROVIDE MEDICAL CARE AT THE HOSPITAL. IN ADDITION, CARSON CITY HOSPITAL IS COMPRISED OF SEVEN HOSPITAL-OWNED PHYSICIAN CLINICS IN A RURAL SETTING. FREE AND REDUCED RATE SPORTS PHYSICALS ARE PROVIDED AT SELECTED CLINICS.
Affiliated health care system	Schedule H, Part VI, Line 6	IN JANUARY 1997, CHN BECAME AFFILIATED WITH THE SPARROW HEALTH SYSTEM OF LANSING, MICHIGAN. THIS AFFILIATION HAS MANY BENEFITS INCLUDING HOLDING DOWN HEALTH CARE COSTS, IMPROVED ACCESS TO SPECIALIZED SERVICES, ACCESS TO INFORMATION SYSTEMS, MANAGED CARE CONTRACTS AND NEW PHYSICIAN RECRUITMENT. CCH IS A MEMBER OF THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND THE MICHIGAN OSTEOPATHIC ASSOCIATION.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT SEALS DO
SECRETARY/TREASURER, MEDICAL DIRECTOR	282820	0	33849	0	0	0	7500	0	5642	0	329811	0	0	0
MICHAEL H MULLINS
PHYSICIAN	359727	0	0	0	0	0	7500	0	273	0	367500	0	0	0
ADAM Z COTE
PHYSICIAN	543789	0	8141	0	14734	0	7500	0	8697	0	582861	0	0	0
CHRISTOPHER E HERALD MD
ER DIRECTOR	311331	0	600	0	0	0	7500	0	7569	0	327000	0	0	0
MATTHEW J THOMPSON
PRESIDENT/CEO	209423	0	600	0	22470	0	7207	0	7214	0	246914	0	0	0
DOUGLAS POFF DO
BOARD MEMBER/PHYSICIAN	171855	0	20771	0	0	0	5873	0	8329	0	206828	0	0	0
DUANE C MILLER
SENIOR VP FINANCE/CFO	150058	0	600	0	0	0	4728	0	6942	0	162328	0	0	0
PARUTAPPA R BHIMALLI
PHYSICIAN	490994	0	0	0	0	0	7500	0	9225	0	507719	0	0	0
NANCY A WEAVER
VP NURSING/CNO	150339	0	600	0	0	0	4719	0	5287	0	160945	0	0	0
NATALIE W BUSLEPP
DIRECTOR OF MEDICAL SERVICES GROUP	112875	0	0	0	39020	0	4104	0	6903	0	162902	0	0	0
JOSEPH B WHITE
PHYSICIAN	586433	0	600	0	17000	0	0	0	7204	0	611237	0	0	0
RAYMOND P ALLARD
PHYSICIAN	498714	0	600	0	0	0	7500	0	1286	0	508100	0	0	0
DAVID J FREESTONE MD
PHYSICIAN/CHIEF OF STAFF	230568	0	71988	0	0	0	7500	0	6900	0	316956	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	Non-fixed payments	Identifier
Return Reference	Schedule J, Part I, Line 7	ReturnReference
Explanation	PHYSICIANS RECEIVED ANNUAL PRODUCTION INCENTIVE COMPENSATION, WHICH IS CALCULATED BASED ON EQUALLING OR EXCEEDING CERTAIN NET PATIENT REVENUE TARGETS.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
MICHIGAN STATE HOSPITAL FINANCE AUTHORITY
A	382889417	54965HKS4	2006-02-01	18000000	HOSPITAL EQUIPMENT LOAN PROGRAM (HELP)	false	false	true
MICHIGAN STATE HOSPITAL FINANCE AUTHORITY
B	382889417	594654HG5	2007-12-18	455937	HOSPITAL EQUIPMENT LOAN PROGRAM (HELP)	false	false	true

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Amount Bond DefeasedAmountBondDefeased	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	3970793	0	18000000	0	0	0	133000	0	0	14012600	3854400	0	2009	false	false	true	true
B	94987	0	455937	0	0	0	0	0	0	0	455937	0	2007	false	false	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Engage Bond Counsel ContractsEngageBondCounselContracts	Any Research AgreementsAnyResearchAgreements	Engage Bond Counsel ResearchEngageBondCounselResearch	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Prcntge Bond Financed PropPrcntgeBondFinancedProp	Remedial Action TakenRemedialActionTaken	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	false	false	false	false	false	false	0.0000	0.0000	0.0000	false	false	0.000000	false	true
B	false	false	false	false	false	false	0.0000	0.0000	0.0000	false	false	0.000000	false	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Term Of GICTermOfGIC	Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
A	false	false	false	true	true	false	0	false	false	false	0	false	false	true
B	false	false	false	true	true	false	0.0	false	false	false	0.0	false	false	true

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	true
B	true

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, LINE 3	THE ORGANIZATION SPENT ITS OWN OPERATING FUNDS AND IN TURN WAS REIMBURSED WITH THE BOND PROCEEDS; THEREFORE THERE ARE NO INTEREST EARNINGS ON THE PROCEEDS.
ISSUER NAME: Michigan State Hospital Finance Authority: No Rebate Due.	Schedule K, Part IV, Line 2c	THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 2/1/2011.
ISSUER NAME: Michigan State Hospital Finance Authority: No Rebate Due.	Schedule K, Part IV, Line 2c	THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 12/18/2012.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
SPARROW HEALTH SYSTEM
M. BRETT, T. OSTRANDER, G. REETZ, AND C. KOSLOSKI ARE CCH BOARD MEMBERS AND SPARROW OFFICERS	357385	MARK BRETT, TOM OSTRANDER, GARY REETZ AND CINDA KOSLOSKI, CARSON CITY HOSPITAL BOARD MEMBERS, SERVE AS THE SENIOR VICE PRESIDENT, AFFILIATE OPERATIONS; VICE PRESIDENT, PROFESSIONAL SERVICES; CONTROLLER; AND DIRECTOR OF DECISION SUPPORT, RESPECTIVELY, FOR SPARROW HEALTH SYSTEM, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2012, CARSON CITY HOSPITAL MADE PAYMENTS TO SPARROW HEALTH SYSTEM IN THE AMOUNT OF $357,385 FOR REIMBURSEMENT OF SUPPLIES AND PHARMACEUTICALS, LABORATORY AND OTHER PATIENT CARE SERVICES, SOFTWARE SUPPORT, EQUIPMENT RENTAL, AND PHYSICIAN RECRUITING.	false
SPARROW HEALTH SYSTEM
M. BRETT, T. OSTRANDER, G. REETZ, AND C. KOSLOSKI ARE CCH BOARD MEMBERS AND SPARROW OFFICERS	197500	MARK BRETT, TOM OSTRANDER, GARY REETZ AND CINDA KOSLOSKI, CARSON CITY HOSPITAL BOARD MEMBERS, SERVE AS THE SENIOR VICE PRESIDENT, AFFILIATE OPERATIONS; VICE PRESIDENT, PROFESSIONAL SERVICES; CONTROLLER; AND DIRECTOR OF DECISION SUPPORT, RESPECTIVELY, FOR SPARROW HEALTH SYSTEM, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2012, CARSON CITY HOSPITAL RECEIVED PAYMENTS FROM SPARROW HEALTH SYSTEM IN THE AMOUNT OF $197,500 FOR REIMBURSEMENT OF SUPPLIES AND PHARMACEUTICALS, OFFICE RENT, AND SUPPORT FOR PSYCHIATRIC MEDICAL EDUCATION.	false

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Delegate broad authority to a committee	Form 990, Part VI, Section A, Line 1a	THE EXECUTIVE COMMITTEE OF THE BOARD SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD, THE PRESIDENT, THE VICE-CHAIRPERSON, THE SECRETARY/TREASURER AND THE MEDICAL DIRECTOR. A SIXTH MEMBER SHALL BE APPOINTED BY THE CHAIRPERSON AND CHOSEN FROM ONE OF THE CLASS B MEMBERS OF THE BOARD. THE CHAIRPERSON SHALL APPOINT REPLACEMENTS WHEN NECESSARY. A MAJORITY OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM. IT SHALL HAVE THE AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE COMMITTEE SHALL MAKE A FULL REPORT OF ITS ACTIONS, IF ANY, AT THE NEXT REGULAR MEETING OF THE BOARD. MEETINGS OF THE COMMITTEE MAY BE HELD AT ANY TIME ON CALL BY THE CHAIRPERSON OF THE BOARD.
DIRECTOR INDEPENDENCE	FORM 990, PART VI, LINE 1B	BOARD OF DIRECTORS MEMBER GARY REETZ RESIGNED HIS POSITION AS A CLASS B (NON-INDEPENDENT SPARROW HEALTH SYSTEMS) BOARD MEMBER IN AUGUST OF 2012 DUE TO HIS RETIREMENT FROM SHS. HE WAS THEN ELECTED TO FILL A CLASS A (INDEPENDENT) VACANCY EFFECTIVE IN SEPTEMBER OF 2012. MR. REETZ'S CLASS B POSITION WAS THEN FILLED BY CINDA KOSLOSKI IN DECEMBER. ALTHOUGH MR. REETZ DID NOT QUALIFY TO BE COUNTED AS INDEPENDENT DUE TO HIS COMPENSATION PRIOR TO HIS RETIREMENT WHICH HE RECEIVED DURING 2012, IN REALITY THERE WAS NEVER A TIME DURING 2012 WHEN NON-INDEPENDENT BOARD MEMBERS MADE UP A MAJORITY OF THE BOARD COMPOSITION.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	CARSON CITY HOSPITAL (CCH) IS ORGANIZED ON A MEMBERSHIP BASIS. THERE ARE TWO CLASSES OF MEMBERS: CLASS A MEMBERSHIP CONSISTS OF THE ORIGINAL DIRECTORS OF CCH, EXCLUDING THOSE DIRECTORS WHO ARE ELECTED OR APPOINTED BY THE CLASS B MEMBER; THE CLASS B MEMBER IS SPARROW HEALTH SYSTEM (SPARROW), AN UNRELATED MICHIGAN NONPROFIT CORPORATION. OTHER THAN SPARROW, THERE SHALL BE NO ADDITIONAL CLASS B MEMBERSHIP INTERESTS WITHOUT THE CONSENT OF SPARROW.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	CLASS A MEMBERS EACH HAVE ONE VOTE FOR PURPOSES OF VOTING BY MEMBERS; THE NUMBER OF VOTES HELD BY THE CLASS B MEMBER (SPARROW) IS PROPORTIONATE TO THE SPARROW PERCENTAGE INTEREST MULTIPLIED BY THE VOTES HELD IN THE AGGREGATE BY BOTH CLASS A AND CLASS B MEMBERS. AT THE ANNUAL MEETING OF THE MEMBERS, THE CLASS A MEMBERS ELECT 9 DIRECTORS OF THE BOARD OF DIRECTORS BY MAJORITY VOTE OF THE CLASS A MEMBERS, AND THE CLASS B MEMBER (SPARROW) ELECTS A NUMBER OF DIRECTORS OF THE BOARD OF DIRECTORS THAT IS CONSISTENT WITH THE CURRENT SPARROW PERCENTAGE INTEREST.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE FOLLOWING ACTIVITIES REQUIRE THE AFFIRMATIVE VOTE OF THE CLASS B MEMBER (SPARROW): 1. AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THE BYLAWS; 2. THE DISSOLUTION, MERGER, SALE, SALE OF SUBSTANTIALLY ALL OF THE ASSETS, LEASE, OR TRANSFER OF CONTROL; 3. THE SALE OF A MAJORITY OWNERSHIP INTEREST IN CCH; 4. THE PUBLICLY RECOGNIZED "AFFILIATION" WITH ANY ORGANIZATION OTHER THAN THE CLASS B MEMBER (SPARROW); 5. APPROVAL OF CCH'S ANNUAL OPERATING BUDGET, WHEN SUCH BUDGET REFLECTS A TOTAL MARGIN OF LESS THAN 2% OF NET REVENUE; 6. APPROVAL OF CCH'S ANNUAL CAPITAL BUDGET, WHEN SUCH BUDGET ANTICIPATES AN ADDITIONAL CAPITAL CONTRIBUTION FROM THE CLASS B MEMBER (SPARROW) BEYOND ITS ORIGINAL CAPITAL CONTRIBUTION; 7. THE INCURRENCE OF ANY DEBT OBLIGATION IN THE AGGREGATE GREATER THAN $500,000; 8. THE APPROVAL OF CAPITAL EXPENDITURES IN EXCESS OF $500,000 (EXCEPT AS TO REPLACE EQUIPMENT); AND 9. ANY ACTION THAT ALLOWS OR FACILITATES THE CREATION OF A NEW CLASS OF MEMBERS OR CREATION OF A MEMBERSHIP INTEREST IN CCH.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	THE FORM 990 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S MANAGEMENT. A BOARD MEETING IS HELD WITH OUR TAX ADVISORS WHERE A COPY OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PROVIDED TO EACH MEMBER OF THE GOVERNING BODY FOR REVIEW BEFORE THE RETURN IS FILED WITH THE IRS. THE BOARD IS GIVEN A SUMMARY OF KEY POINTS REGARDING THE FORM 990, AND IS ALLOWED TO ASK ANY QUESTIONS THEY MAY HAVE. ONCE ALL BOARD MEMBERS HAVE REVIEWED THE RETURN, IT IS THEN SUBMITTED TO THE IRS.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	CONFLICT OF INTEREST QUESTIONNAIRES ARE DISTRIBUTED TO ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO DETERMINE WHETHER ANY POTENTIAL CONFLICTS OF INTEREST EXIST ON AN ANNUAL BASIS. THE HOSPITAL EXECUTIVE COMMITTEE, WHICH INCLUDES THE PRESIDENT OF THE BOARD OF DIRECTORS, DISCUSSES THE CONFLICT OF INTEREST QUESTIONNAIRES TO DETERMINE WHETHER AN ACTUAL CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE PERSON WITH THE CONFLICT IS RECUSED FROM TAKING PART IN ANY DECISIONS CONCERNING THE CONFLICTING ISSUE.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	THE ORGANIZATION'S BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE COMPENSATION FOR THE ORGANIZATION'S PRESIDENT/CEO. THE BOARD PRESIDENT/CEO IS REMOVED FROM THE BOARD DISCUSSIONS TO PREVENT HIM FROM DISCUSSING AND DETERMINING HIS OWN COMPENSATION. THE BOARD OF DIRECTORS USES COMPENSATION STUDIES AND WAGE SURVEYS IN DETERMINING THE AMOUNT OF COMPENSATION FOR THE CEO, AND THEIR DISCUSSIONS ARE DOCUMENTED IN THE BOARD MEETING MINUTES. COMPENSATION FOR THE CURRENT YEAR IS DISCUSSED AND APPROVED IN THE PREVIOUS YEAR DURING THE BUDGET APPROVAL PROCESS. THE 2012 COMPENSATION WAS REVIEWED AND APPROVED DURING NOVEMBER/DECEMBER 2011 DURING THE ANNUAL BUDGETING PROCESS; THE 2013 COMPENSATION WAS REVIEWED AND APPROVED DURING NOVEMBER/DECEMBER 2012 DURING THE ANNUAL BUDGETING PROCESS.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	THE ORGANIZATION'S BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE COMPENSATION FOR ALL POSITIONS, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES. THE BOARD OF DIRECTORS USES COMPENSATION STUDIES AND WAGE SURVEYS IN DETERMINING THE AMOUNT OF COMPENSATION FOR ALL POSITIONS, AND THEIR DISCUSSIONS ARE DOCUMENTED IN THE BOARD MEETING MINUTES. THE 2012 COMPENSATION WAS REVIEWED AND APPROVED AT THE END OF 2011 DURING THE ANNUAL BUDGETING PROCESS.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	AN ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. AS A HOSPITAL, THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS AN ATTACHMENT TO ITS FORM 990, WHICH IS A REQUIRED DISCLOSURE PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104.
Other changes in net assets or fund balances	Form 990 , Part XI, Line 9	CHANGE IN PENSION LIABILITY - -511792; CHANGE IN CARSON FOUNDATION NET ASSETS INCLUDED IN AUDITED FINANCIAL STATEMENTS - -4990;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	CARSON FOUNDATION INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	406 E ELM ST	AddressLine1
City	CARSON CITY	City
State	MI	State
ZIP Code	488119693	ZIPCode

Field	Value	IRS element (for citing)
Primary Activities	ENHANCE RESOURCES FOR HIGH QUALITY AND ACCESSIBLE HEALTH CARE	PrimaryActivities
Legal Domicile State	MI	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	11 - Type I	PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CARSON CITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Controlled Org	true	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg