SPARROW CARSON HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: SPARROW CARSON HOSPITAL (EIN 38-1490180)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-14
IRS object ID: 201223199349300017
Schema version: 2011v1.2
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 G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-14T08:00:25-06:00	Timestamp
Tax Period End Date	2011-12-31	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	2011-01-01	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	2012-11-05	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	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	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	61352450	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	7	NbrIndependentVotingMembers
Total Nbr Employees	718	TotalNbrEmployees
Total Nbr Volunteers	145	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	173923	ContributionsGrantsPriorYear
Contributions Grants Current Year	179222	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	56098857	ProgramServiceRevenuePriorYear
Program Service Revenue CY	59862979	ProgramServiceRevenueCY
Investment Income Prior Year	268368	InvestmentIncomePriorYear
Investment Income Current Year	164770	InvestmentIncomeCurrentYear
Other Revenue Prior Year	544801	OtherRevenuePriorYear
Other Revenue Current Year	602659	OtherRevenueCurrentYear
Total Revenue Prior Year	57085949	TotalRevenuePriorYear
Total Revenue Current Year	60809630	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	19979	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	29805940	SalariesEtcPriorYear
Salaries Etc Current Year	32574506	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1052	TotalFundrsngExpCurrentYear
Other Expense Prior Year	25973959	OtherExpensePriorYear
Other Expenses Current Year	27476512	OtherExpensesCurrentYear
Total Expenses Prior Year	55779899	TotalExpensesPriorYear
Total Expenses Current Year	60070997	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1306050	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	738633	RevenuesLessExpensesCY
Total Assets BOY	46633993	TotalAssetsBOY
Total Assets EOY	46428348	TotalAssetsEOY
Total Liabilities BOY	23285826	TotalLiabilitiesBOY
Total Liabilities EOY	23228049	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	23348167	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	23200299	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
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	45201899	Expense
Grants	19979	Grants
Revenue	52532051	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, DO. 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, 2011, CCH PROVIDED OVER $2 MILLION IN UNCOMPENSATED CARE. DURING THE YEAR ENDED DECEMBER 31, 2011, CCH PROVIDED 6,564 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 3.02 DAYS. THERE WERE ALSO 12,497 EMERGENCY ROOM VISITS, 67,245 OUTPATIENT HOSPITAL VISITS, 1,874 HOSPITAL ADMISSIONS, AND 319 BIRTHS DURING THE YEAR. CCH PERFORMED 5,940 SURGERIES, 193,874 LAB TESTS, 13,323 DIAGNOSTIC IMAGING EXAMS, 4,102 CT SCANS, AND 2,947 M.R.I. SCANS. THE ESTIMATED TOTAL LOCAL ECONOMIC IMPACT FOR THE YEAR WAS $30,139,891.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1504356	Expense
Grants	0	Grants
Revenue	1729023	Revenue
Description	ITHACA FAMILY CARE CENTER (IFCC) IS AN OFFICE WITH 3 PHYSICIANS 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	1192853	Expense
Grants	0	Grants
Revenue	1400611	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	1132381	Expense
Grants	0	Grants
Revenue	4201294	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	1132381	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	4201294	TotalOfOtherProgramServiceRev
Total Program Service Expense	49031489	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	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	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	false	RelatedEntity
Related Org Controlled Entity	false	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	179	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	718	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	7	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	false	LocalChapters
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
PATRICK E BURNS
SECRETARY/TREASURER	2.00	X	X	0	0	0
DAVID FREESTONE MD
BOARD MEMBER/PHYSICIAN	40.00	X		240625	0	13640
DEBBY CASSADY
BOARD MEMBER	2.00	X		0	0	0
DOUGLAS POFF DO
BOARD MEMBER/PHYSICIAN	40.00	X		200582	0	14572
GARY REETZ
BOARD MEMBER	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
ROBERT SEALS DO
BOARD MEMBER/PHYSICIAN	40.00	X		270372	0	12602
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
BRUCE L TRAVERSE
PRESIDENT/CEO	40.00		X	239392	0	7734
DUANE C MILLER
CFO	40.00		X	150658	0	11262
MATTHEW J THOMPSON
COO	40.00		X	161307	0	7438
NANCY A WEAVER
DIRECTOR OF PATIENT SERVICES	40.00		X	143944	0	9374
NATALIE W BUSLEPP
DIRECTOR OF MEDICAL SERVICES GROUP	40.00		X	110535	0	10503
RICHARD D TERRY
CIO	40.00		X	103289	0	6340
CHRISTOPHER E HERALD
ER DIRECTOR	40.00			301475	0	14503	X
ADAM Z COTE
PHYSICIAN	40.00			346684	0	4811		X
BRUCE MURRAY
PHYSICIAN	40.00			318431	0	14161		X
JANMEET SAHOTA
PHYSICIAN	40.00			447609	0	14716		X
MICHAEL H MULLINS
PHYSICIAN	40.00			346171	0	7623		X
PARUTAPPA R BHIMALLI
PHYSICIAN	40.00			489493	0	18075		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3870567	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	167354	TotalOtherCompensation
Number Individuals GT100 K	46	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 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	239539
GARY RALPH
400 WILDWOOD DR	EAST LANSING	MI	48823	PHYSICIAN CONSULTING SERVICES	163350
PROMED
17197 LAUREL PARK N STE 521	LIVONIA	MI	48152	HOME HEALTH CARE BILLING CONSULTING	149584
LIFE CARE SLEEP AND HEALTH CENTER LLC
7200 W SAGINAW HWY SUITE 2	LANSING	MI	48917	SLEEP STUDY CONSULTING	145825

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Fundraising Events	51800	FundraisingEvents
Government Grants	6720	GovernmentGrants
All Other Contributions	120702	AllOtherContributions
Total Contributions	179222	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621300	57765950	57765950
MEDICARE/MEDICAID "HITECH" REVENUE	900099	2097029	2097029

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	59862979	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	263679	TotalRevenueColumn
Exclusion	$263,679	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	591282	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	441006	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	150276	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	150276	TotalRevenueColumn
Exclusion	$150,276	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	0	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	98909	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	-98909	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-98909	TotalRevenueColumn
Exclusion	-$98,909	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	16484	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	51800	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	2905	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	13579	TotalRevenueColumn
Exclusion	$13,579	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Gaming	1582	GrossIncomeGaming

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	1582	TotalRevenueColumn
Exclusion	$1,582	ExclusionAmount

Net Income Or Loss NetIncomeOrLoss

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

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
CAFETERIA/COFFEE SHOP/VENDING	722219	323974	$323,974
MISCELLANEOUS	900099	113248	$113,248

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	437222	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	60809630	TotalRevenueColumn
Related Or Exempt Function Income	59862979	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$767,429	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	19979	Total
Program Services	19979	ProgramServices

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	2030147	Total
Program Services	1342727	ProgramServices
Management And General	687420	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	26402918	Total
Program Services	23491354	ProgramServices
Management And General	2911564	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	789777	Total
Program Services	589803	ProgramServices
Management And General	199974	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1498094	Total
Program Services	1107947	ProgramServices
Management And General	390147	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1853570	Total
Program Services	1620200	ProgramServices
Management And General	233370	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	118520	Total
Management And General	118520	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	70374	Total
Management And General	70374	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	40382	Total
Management And General	40382	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	4083309	Total
Program Services	1575732	ProgramServices
Management And General	2507577	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	533783	Total
Program Services	8051	ProgramServices
Management And General	525732	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2838495	Total
Program Services	2347267	ProgramServices
Management And General	491228	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	745207	Total
Program Services	211171	ProgramServices
Management And General	534036	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2923965	Total
Program Services	1544985	ProgramServices
Management And General	1378980	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	117110	Total
Program Services	114838	ProgramServices
Management And General	2272	ManagementAndGeneral

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	419059	Total
Program Services	419059	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1859186	Total
Program Services	1859186	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	833937	Total
Program Services	81714	ProgramServices
Management And General	752223	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
DIRECT PATIENT CARE SUPPLIES & EXPENSES	8309383	8309383
BAD DEBT EXPENSE	2333022	2333022
PROVIDER/OTHER TAXES	1725486	1689854	35632
RECRUITING	238633	218072	20561

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	286661	Total
Program Services	147145	ProgramServices
Management And General	138464	ManagementAndGeneral
Fundraising	1052	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	60070997	Total
Program Services	49031489	ProgramServices
Management And General	11038456	ManagementAndGeneral
Fundraising	1052	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	4202	BOY
EOY	4633	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	6202651	BOY
EOY	3996424	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	50900	BOY
EOY	28207	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	8138330	BOY
EOY	10007350	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	59492	BOY
EOY	43588	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1065956	BOY
EOY	987209	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1230733	BOY
EOY	2136643	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	45885042	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	22577244	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	23913240	BOY
EOY	23307798	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	5100698	BOY
EOY	5065752	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	239804	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	627987	BOY
EOY	610940	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	46633993	BOY
EOY	46428348	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	4213919	BOY
EOY	6029100	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	15904911	BOY
EOY	15147534	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1492963	BOY
EOY	1318003	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	25010	BOY
EOY	22510	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1649023	BOY
EOY	710902	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	23285826	BOY
EOY	23228049	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	23141058	BOY
EOY	22936749	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	207109	BOY
EOY	263550	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	23348167	BOY
EOY	23200299	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	46633993	BOY
EOY	46428348	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	738633	ReconcilationRevenueExpenses
Reconcilation Other Changes	-886501	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
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	$3,234	OtherActivitiesAmount
Total Lobbying Expenditures IIB	3234	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; 13.92% 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	31154525	OtherCostOrOtherBasis
Depreciation	13250793	Depreciation
Book Value	17903732	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1471761	OtherCostOrOtherBasis
Depreciation	532525	Depreciation
Book Value	939236	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	12287183	OtherCostOrOtherBasis
Depreciation	8793926	Depreciation
Book Value	3493257	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	239930	OtherCostOrOtherBasis
Book Value	239930	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	23307798	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DEFINED BENEFIT PENSION LIABILITY	Description
Amount	$710,902	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	710902	TotalOfAmounts
Total Revenue	60809630	TotalRevenue
Total Expenses	60070997	TotalExpenses
Excess Or Deficit For Year	738633	ExcessOrDeficitForYear
Donated Services And Facilities	-200065	DonatedServicesAndFacilities
Other	-$686,436	OtherAmount
Total Adjustments	-886501	TotalAdjustments
Excess Or Deficit Per FS	-147868	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	59885652	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-200065	NetUnrealizedGainsInvestments
Other Revenues	2905	OtherRevenues
Revenue Not Rptd F990	-197160	RevenueNotRptdF990
Revenue Subtotal	60082812	RevenueSubtotal
Investment Expenses Not Included	40382	InvestmentExpensesNotIncluded
Other Revenues Not Included	686436	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	726818	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	60809630	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	60033520	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	2905	OtherExpensesIncluded
Expenses Not Rptd F990	2905	ExpensesNotRptdF990
Expenses Subtotal	60030615	ExpensesSubtotal
Investment Expenses Not Included2	40382	InvestmentExpensesNotIncluded2
Other Expenses Not Included	0	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	40382	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	60070997	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	FIN 48 (ASC 740) footnote	Identifier
Return Reference	Schedule D, Part X, Line 2	ReturnReference
Explanation	CARSON CITY HOSPITAL IS A NONPROFIT, TAX-EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOMES PURSUANT TO SECTION 501(A). ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. HOWEVER, INCOME NOT DIRECTLY RELATED TO THE HOSPITAL'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE MORE LIKELY THAN NOT TEST, NO TAX BENEFIT IS RECORDED. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX LIABILITIES AND INCLUDES THESE IN INTEREST AND INCOME TAX EXPENSE. THE HOSPITAL HAS NO AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AS OF DECEMBER 31, 2011 OR 2010. THE HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX LIABILITIES TO SIGNIFICANTLY CHANGE OVER THE NEXT TWELVE MONTHS. THE HOSPITAL IS NO LONGER SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR YEARS BEFORE 2008.	Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SUMMER DANCE	NameOfEvent1
Gross Receipts Event1	68284	GrossReceiptsEvent1
Charitable Contributions Event1	51800	CharitableContributionsEvent1
Gross Revenue Event1	16484	GrossRevenueEvent1
Food And Beverage Event1	2905	FoodAndBeverageEvent1
Gross Revenue Event2	0	GrossRevenueEvent2
Gross Revenue Other Events	0	GrossRevenueOtherEvents
Gross Receipts Total	68284	GrossReceiptsTotal
Charitable Contributions Total	51800	CharitableContributionsTotal
Gross Revenue Total Events	16484	GrossRevenueTotalEvents
Cash Prizes Total Events	0	CashPrizesTotalEvents
Non Cash Prizes Total Events	0	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	0	RentFacilityCostsTotalEvents
Food And Beverage Total Events	2905	FoodAndBeverageTotalEvents
Entertainment Total Events	0	EntertainmentTotalEvents
Other Direct Expenses Total Events	0	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	2905	DirectExpenseSummaryEvents
Net Income Summary	13579	NetIncomeSummary

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	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	2162964	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	2162964	NetCommunityBenefitExpense
Percent Of Total Expense	0.03750	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	22	NumberOfActivitiesOrPrograms
Persons Served	30157	PersonsServed
Total Community Benefit Expense	11714532	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7895636	DirectOffsettingRevenue
Net Community Benefit Expense	3818896	NetCommunityBenefitExpense
Percent Of Total Expense	0.06610	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

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

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	22	NumberOfActivitiesOrPrograms
Persons Served	30157	PersonsServed
Total Community Benefit Expense	13877496	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7895636	DirectOffsettingRevenue
Net Community Benefit Expense	5981860	NetCommunityBenefitExpense
Percent Of Total Expense	0.10360	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	84	NumberOfActivitiesOrPrograms
Persons Served	3275	PersonsServed
Total Community Benefit Expense	2281433	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	2281433	NetCommunityBenefitExpense
Percent Of Total Expense	0.03950	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	19	PersonsServed
Total Community Benefit Expense	218126	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16262	DirectOffsettingRevenue
Net Community Benefit Expense	201864	NetCommunityBenefitExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13	NumberOfActivitiesOrPrograms
Persons Served	88440	PersonsServed
Total Community Benefit Expense	11488220	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9616313	DirectOffsettingRevenue
Net Community Benefit Expense	1871907	NetCommunityBenefitExpense
Percent Of Total Expense	0.03240	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
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)
Number Of Activities Or Programs	97	NumberOfActivitiesOrPrograms
Persons Served	150	PersonsServed
Total Community Benefit Expense	19979	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	19979	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	198	NumberOfActivitiesOrPrograms
Persons Served	91884	PersonsServed
Total Community Benefit Expense	14007758	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9632575	DirectOffsettingRevenue
Net Community Benefit Expense	4375183	NetCommunityBenefitExpense
Percent Of Total Expense	0.07570	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	220	NumberOfActivitiesOrPrograms
Persons Served	122041	PersonsServed
Total Community Benefit Expense	27885254	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17528211	DirectOffsettingRevenue
Net Community Benefit Expense	10357043	NetCommunityBenefitExpense
Percent Of Total Expense	0.17930	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

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

Economic Development EconomicDevelopment

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

Community Support CommunitySupport

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

Environmental Improvements EnvironmentalImprovements

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

Leadership Development LeadershipDevelopment

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

Coalition Building CoalitionBuilding

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

Health Improvement Advocacy HealthImprovementAdvocacy

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

Workforce Development WorkforceDevelopment

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

Other Other

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

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	$2,333,022	BadDebtExpenseAmount
Amount Attributable To	45599	AmountAttributableTo
Amount Reimbursed By Medicare	10152773	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	12475165	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2322392	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 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
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
PHYSICAL REHABILITATION CARE CENTER
602 E ELM STREET	CARSON CITY	MI	48811	OUTPATIENT REHABILITATION CLINIC
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
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
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 (16 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)	2,333,022
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. OF THE $9.6 MILLION IN REVENUE THAT IS BROUGHT IN FROM THE PHYSICIAN CLINIC SETTING, $100 FROM BLOOD PRESSURE CHECKS, $5,300 FROM CHILD IMMUNIZATIONS, AND $230 FROM CHOLESTEROL TESTING.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. 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. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. THE HOSPITAL DOES NOT ACCRUE INTEREST ON ANY OF ITS ACCOUNTS RECEIVABLE. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVELY CALCULATED ADJUSTMENTS ARISING UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED. BAD DEBT REPORTED IN PART III, LINE 2 IS REPORTED AT THE ESTIMATED NET REALIZABLE VALUE, THE SAME METHODOLOGY USED TO REPORT BAD DEBT IN THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. 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.
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	ALTHOUGH NOT 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 - MEDICAL INDIGENCY - INSURANCE STATUS - UNINSURED DISCOUNT - MEDICAID/MEDICARE THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS CURRENTLY UNDER REVIEW, AND THE HOSPITAL IS CONSIDERING ADDING SPECIFIC INFORMATION RELATED THE FACTORS USED IN DETERMINING THE BASIS FOR AMOUNTS CHARGED TO PATIENTS.
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 15e	(1) CARSON CITY HOSPITAL - IF AN ACCOUNT IS DELINQUENT BY 90 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 19d	(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). AN ON-SITE 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 2011, CARSON CITY HOSPITAL DEMONSTRATED THE MEANINGFUL USE OF ITS CERTIFIED EHR TECHNOLOGY AND WAS ABLE TO RECOGNIZE APPROXIMATELY $2.1 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.
State filing of community benefit report	Schedule H, Part VI, Line 7	MI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CARSON CITY FRONTIER DAYS INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	123 MAIN STREET	AddressLine1
Address Line2	PO BOX 340	AddressLine2
City	CARSON CITY	City
State	MI	State
ZIP Code	48811	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	386111280	EINOfRecipient
IRC Section	501(C)(4)	IRCSection
Amount Of Cash Grant	7519	AmountOfCashGrant
Amount Of Non Cash Assistance	0	AmountOfNonCashAssistance
Method Of Valuation	N/A	MethodOfValuation
Description Of Non Cash Assistance	N/A	DescriptionOfNonCashAssistance
Purpose Of Grant	N/A	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	0	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedures for monitoring use of grant funds	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	THE HOSPITAL MAKES GRANTS TO VARIOUS COMMUNITY ORGANIZATIONS. GRANTS MADE ARE UNRESTRICTED AND CAN BE USED IN ANY WAY THE DONEE ORGANIZATION SEES FIT TO FURTHER ITS MISSION.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Housing Allowance Or Residence	X	HousingAllowanceOrResidence
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
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)

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
215738	0	49871	0	4763	0	7350	0	5252	0	282974	0	0	0
JANMEET SAHOTA
447464	0	0	0	145	0	7350	0	7366	0	462325	0	0	0
MICHAEL H MULLINS
345835	0	0	0	336	0	7350	0	273	0	353794	0	0	0
ADAM Z COTE
346684	0	0	0	0	0	0	0	4811	0	351495	0	0	0
CHRISTOPHER E HERALD
300200	0	600	0	675	0	7350	0	7153	0	315978	0	0	0
MATTHEW J THOMPSON
158962	0	0	0	2345	0	4860	0	2578	0	168745	0	0	0
BRUCE L TRAVERSE
187471	0	10100	0	41821	0	7209	0	525	0	247126	0	0	0
DOUGLAS POFF DO
172401	0	28181	0	0	0	6116	0	8456	0	215154	0	0	0
DAVID FREESTONE MD
189510	0	50485	0	630	0	7350	0	6290	0	254265	0	0	0
DUANE C MILLER
147584	0	600	0	2474	0	4710	0	6552	0	161920	0	0	0
BRUCE MURRAY
317524	0	600	0	307	0	7350	0	6811	0	332592	0	0	0
PARUTAPPA R BHIMALLI
474774	0	0	0	14719	0	7350	0	10725	0	507568	0	0	0
NANCY A WEAVER
138808	0	2670	0	2466	0	4477	0	4897	0	153318	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Housing allowance or residence for personal use	Schedule J, Part I, Line 1a	MATTHEW J. THOMSON (COO) RECEIVED A HOUSING ALLOWANCE IN THE AMOUNT OF $300 DURING 2011. THE AMOUNT WAS INCLUDED IN HIS 2011 FORM W-2 AS TAXABLE COMPENSATION.
Non-fixed payments	Schedule J, Part I, Line 7	BRUCE L. TRAVERSE (PRESIDENT/CEO) RECEIVED A DISCRETIONARY QUARTERLY STIPEND IN THE AMOUNT OF $9,500 DURING 2011. THE AMOUNT WAS INCLUDED IN HIS 2011 FORM W-2 AS TAXABLE COMPENSATION.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

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

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

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
3601603	0	18000000	0	0	0	133000	0	0	14012600	3854400	0	2009	false	false	true	true
85488	0	455937	0	0	0	0	0	0	0	455937	0	2007	false	false	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
false	false	false	false	0.0000	0.0000	0.0000	true
false	false	false	false	0.0000	0.0000	0.0000	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
false	true	false	false	false	true
false	true	false	false	false	true

Field	Value	IRS element (for citing)
Fed Tax Requirements Compliance	X	FedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
TOTAL PROCEEDS OF ISSUE	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.
Procedures to take corrective action	Schedule K, Part V	THE ORGANIZATION WORKS DIRECTLY WITH THE MICHIGAN HOSPITAL ASSOCIATION (MHA) TO ENSURE COMPLIANCE, AS THE BONDS ARE PART OF A POOLED FINANCING AND ARE ISSUED TO MHA.

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 AND G. REETZ ARE CCH BOARD MEMBERS AND SPARROW OFFICERS	466097	MARK BRETT, TOM OSTRANDER AND GARY REETZ, CARSON CITY HOSPITAL BOARD MEMBERS, SERVE AS THE SENIOR VICE PRESIDENT, AFFILIATE OPERATIONS; VICE PRESIDENT, PROFESSIONAL SERVICES; AND CONTROLLER, RESPECTIVELY, FOR SPARROW HEALTH SYSTEM, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2011, CARSON CITY HOSPITAL MADE PAYMENTS TO SPARROW HEALTH SYSTEM IN THE AMOUNT OF $406,135 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 AND G. REETZ ARE CCH BOARD MEMBERS AND SPARROW OFFICERS	204784	MARK BRETT, TOM OSTRANDER AND GARY REETZ, CARSON CITY HOSPITAL BOARD MEMBERS, SERVE AS THE SENIOR VICE PRESIDENT, AFFILIATE OPERATIONS; VICE PRESIDENT, PROFESSIONAL SERVICES; AND CONTROLLER, RESPECTIVELY, FOR SPARROW HEALTH SYSTEM, AN UNRELATED ORGANIZATION. FOR THE YEAR ENDED DECEMBER 31, 2011, CARSON CITY HOSPITAL RECEIVED PAYMENTS FROM SPARROW HEALTH SYSTEM IN THE AMOUNT OF $204,784 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
Description of other program services	Form 990, Part III, Line 4d	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
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.
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. 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 2011 COMPENSATION WAS REVIEWED AND APPROVED DURING NOVEMBER/DECEMBER 2010 DURING THE ANNUAL BUDGETING PROCESS; THE 2012 COMPENSATION WAS REVIEWED AND APPROVED DURING NOVEMBER/DECEMBER 2011 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 2011 COMPENSATION WAS REVIEWED AND APPROVED AT THE END OF 2010 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 5	NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -200065; CHANGE IN PENSION LIABILITY - -686436;