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
2019
Open to Public
Inspection
Name of the organization
SPARROW IONIA HOSPITAL
 
Employer identification number

38-3218134
Return Reference Explanation
FORM 990 ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART IV, QUESTION 4 - THE ORGANIZATION DOES NOT ENGAGE IN DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION DOES HAVE MEMBERSHIPS IN VARIOUS TRADE ASSOCIATIONS THAT USE A PORTION OF DUES PAID TO THE TRADE ASSOCIATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THE APPLICABLE TRADE ASSOCIATION INDUSTRIES, THUS INDIRECTLY BENEFITING THE ORGANIZATION. THE PERCENTAGE OF DUES ALLOCATED TO THIS INDUSTRY-WIDE LOBBYING ACTIVITY IS MINOR AND IS NOT CONSIDERED BY THE ORGANIZATION AS LOBBYING ACTIVITIES REQUIRED FOR DISCLOSURE ON SCHEDULE C, PART II.
FORM 990, PAGE 2, PART III, LINE 4B SPARROW IONIA HOSPITAL'S EMERGENCY SERVICES ARE TYPICAL OF A SMALL RURAL FACILITY. SPARROW IONIA HOSPITAL PROVIDES 24 HOURS A DAY, 7 DAYS A WEEK NURSING AND PHYSICIAN SERVICES. NURSING STAFF AND PHYSICIANS ARE ON-SITE 100% OF THE TIME. A SCREENING EXAM IS PROVIDED TO EVERYONE WHO PRESENTS FOR SERVICES PRIOR TO ANY FINANCIAL INFORMATION BEING OBTAINED OR CHARGES DISCUSSED WITH PATIENTS, IN ACCORDANCE WITH EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT. THERE WERE 16,655 VISITS TO THE EMERGENCY DEPARTMENT FOR THE YEAR ENDED DECEMBER 31, 2019. SPARROW IONIA HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE WITH REIMBURSEMENTS RATES AT OR BELOW COSTS. ADDITIONALLY, SPARROW IONIA HOSPITAL'S CHARITY CARE POLICY COVERS ALL SERVICES PROVIDED IN THE EMERGENCY DEPARTMENT, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALIFY.
FORM 990, PAGE 2, PART III, LINE 4D ALL OTHER PROGRAM SERVICES INCLUDES SERVICES SUCH AS RADIOLOGY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL THERAPY, INFUSION SERVICES, AS WELL AS INPATIENT HOSPIAL SERVICES.
FORM 990, PAGE 6, PART VI, LINE 2 VIRGIL BIGGS TOM DICKINSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 6 SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW IONIA HOSPITAL AND HAS 100% OWNERSHIP.
FORM 990, PAGE 6, PART VI, LINE 7A SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, AND REMOVE DIRECTORS OF SPARROW IONIA HOSPITAL. THE PRESIDENT OF THE MEDICAL STAFF, WHICH IS A MEMBER OF THE GOVERNING BODY, IS ELECTED BY THE MEDICAL STAFF OF SPARROW IONIA HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7B SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, AND REMOVE DIRECTORS OF SPARROW IONIA HOSPITAL. SPARROW HEALTH SYSTEM ALSO HAS THE AUTHORITY TO APPROVE DECISIONS OF THE SPARROW IONIA HOSPITAL BOARD WHEN IT IS DEEMED NECESSARY.
FORM 990, PAGE 6, PART VI, LINE 11B COPIES OF THE 2019 FORM 990 ARE REVIEWED BY MANAGEMENT. ONCE MANAGEMENT COMPLETED ITS REVIEW OF THE FORM 990 COPIES WERE PROVIDED AT THE FALL 2020 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON.
FORM 990, PAGE 6, PART VI, LINE 12C 1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON).
FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, PAGE 6, PART VI, LINE 15B THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE ON SEVERAL INTERNET WEBSITES, INCLUDING THE NMSIR AND MSHFA WEBSITES, AS WELL AS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G NURSING AGENCY STAFFING 184,376 0 0 CONTRACTED PHYSICIAN SERVICES 3,732,865 0 0 LAB SERVICES 1,779,165 0 0 MRI SERVICES 485,100 0 0 SLEEP STUDIES SERVICES 137,825 0 0 MISCELLANEOUS PROFESSIONAL 271,014 159,711 0 SECURITY 0 147,134 0 LAUNDRY & LINEN 0 114,161 0 GROUNDS 0 70,307 0 TOTAL 6,590,345 491,313 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


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