4A (Expenses $ 349724063 including grants of $ 69473) (Revenue $ 465479258)
SPARROW HOSPITAL HAS, SINCE ITS INCEPTION IN 1896, PROVIDED CARE TO PEOPLE REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SPARROW IS A NON-PROFIT COMMUNITY-GOVERNED HOSPITAL AND THE FLAGSHIP OF SPARROW HEALTH SYSTEM, A COMPREHENSIVE INTEGRATED HEALTH DELIVERY SYSTEM COMMITTED WITHIN ITS RESOURCES TO IMPROVING THE HEALTH STATUS OF ALL PEOPLE THROUGHOUT THE MID-MICHIGAN REGION BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME. SPARROW HOSPITAL IS A 703-BED, MAJOR TEACHING HOSPITAL (AFFILIATED WITH MICHIGAN STATE UNIVERSITY'S COLLEGES OF OSTEOPATHIC MEDICINE, HUMAN MEDICINE AND NURSING) AND THE MOST COMPREHENSIVE, ACUTE CARE CENTER IN MID-MICHIGAN. SPARROW IS THE REGIONAL MEDICAL CENTER FOR: PEDIATRICS CANCER CARE, INCLUDING RADIATION THERAPY TRAUMA CARE NEUROLOGICAL CARE HIGH-RISK OBSTETRICS NEONATAL INTENSIVE CARE BEHAVIORAL HEALTH CARDIOVASCULAR SERVICES IN 2021, SPARROW TREATED OVER 34,000 INPATIENTS, PROVIDED SERVICES TO 142,580 EMERGENCY MEDICINE PATIENTS, 297,566 URGENT CARE PATIENTS, NEARLY 10,000 WALK-IN CLINIC PATIENTS, AND CONDUCTED TENS OF THOUSANDS OF VIDEO VISITS. TODAY'S SPARROW HEALTH SYSTEM BLENDS THE KNOWLEDGE AND EXPERTISE OF OVER 1,260 PHYSICIANS, ABOUT 9,000 CAREGIVERS AND ABOUT 1,500 VOLUNTEERS WITH THE MOST ADVANCED TECHNOLOGY, SERVING AS A COMPREHENSIVE HEALTH SYSTEM FOR A CORE EIGHT-COUNTY POPULATION AND BEYOND. IN ADDITION, MORE PEOPLE CHOOSE SPARROW FOR THEIR MATERNITY NEEDS (ABOUT 4,000 DELIVERIES ANNUALLY), REHABILITATION, AND EMERGENCY TREATMENT THAN ANY OTHER HOSPITAL IN MID-MICHIGAN. SPARROW HAS ACHIEVED A NATIONAL BENCHMARK IN QUALITY CARE FOR MOTHERS AND BABIES, AS MID-MICHIGAN'S ONLY BABY-FRIENDLY HOSPITAL, A GLOBAL PROGRAM OF THE WORLD HEALTH ORGANIZATION (WHO) AND THE UNITED NATIONS CHILDREN'S FUND (UNICEF). SPARROW HAS UNDERTAKEN A VARIETY OF MEASURES TO IMPROVE MATERNAL AND INFANT HEALTH. AN OUTPATIENT BREASTFEEDING CLINIC SUPPORTING BREASTFEEDING MOTHERS AND INFANTS IS HELD TWICE A WEEK IN OUR PEDIATRICS SUBSPECIALTY CLINIC. SPARROW ALSO SPONSORS THE BABY CAF, A COMMUNITY RESOURCE FREE OF CHARGE TO NURSING MOTHERS TO OBTAIN BREASTFEEDING SUPPORT, AS WELL AS PEER SUPPORT FROM OTHER NEW MOTHERS. WE ALSO WORK WITH VALUABLE PARTNERS TO OFFER FREE SERVICES TO PARENTS AND CHILDREN. SPARROW WORKS WITH UNIVERSITY OF MICHIGAN PEDIATRIC OPHTHALMOLOGY TO PROVIDE AN EYE CLINIC WEEKLY IN OUR PEDIATRICS SUBSPECIALTY CLINIC. SPARROW ALSO PARTNERS WITH THE INGHAM COUNTY HEALTH DEPARTMENT AND HEALTHY START TO PROVIDE A FREE MONTHLY CLASS FOR HEALTH DEPARTMENT PATIENTS, INCLUDING A TOUR OF SPARROW LABOR AND DELIVERY, AND INFORMATION ABOUT WHAT TO EXPECT WHEN YOU COME TO THE HOSPITAL TO HAVE YOUR BABY. SPARROW ALSO HAS A PARTNERSHIP WITH MICHIGAN MEDICINE (THE UNIVERSITY OF MICHIGAN) TO OVERSEE THE SPARROW CHILDREN'S CENTER. THIS ALLOWS BROADENED PEDIATRIC SPECIALTY SERVICES FOR THE REGION AND HELP ENSURE FAMILIES STAY CLOSE TO HOME, INSTEAD OF TRAVELING GREAT DISTANCES TO SEEK CARE FOR THEIR CHILDREN. SPARROW HEALTH SYSTEM'S REACH EXTENDS FAR BEYOND THE ACUTE CARE SETTING OF THE HOSPITAL. THERE ARE MANY WAYS OUR STAFF PROACTIVELY SUPPORTS THE COMMUNITY, ESPECIALLY THOSE WHO HAVE THE GREATEST NEED. BECAUSE OF SPARROW'S COMMITMENT, THE PEOPLE OF MID MICHIGAN HAVE ACCESS TO THE FULL RANGE OF COMPREHENSIVE ACUTE CARE SERVICES AND THE LATEST MEDICAL ADVANCES WITHOUT TRAVELING GREAT DISTANCES. THESE SERVICES ARE AVAILABLE TO ALL MID MICHIGAN RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. PROVIDING ACCESS TO COVID-19 TESTING AND VACCINES: IN 2021, SPARROW WAS A NATIONAL LEADER IN PROVIDING ACCESS TO COVID-19 TESTING AND VACCINES TO PEOPLE FROM THROUGHOUT THE STATE. SPARROW WAS AMONG THE FIRST HOSPITALS TO OFFER INPATIENT TESTING FOR THE VIRUS AND OPENED AN INNOVATIVE DRIVE-THRU TESTING/VACCINE SITE AT AN OLD SEARS AUTOMOTIVE CENTER IN LANSING. IT HAS ALSO DISTRIBUTED THE VACCINE THROUGH HIGH SCHOOL CLINICS AND TO UNDERSERVED AREAS THROUGH A MOBILE HEALTH CLINIC. SPARROW HAS PERFORMED MORE THAN 800,000 COVID TESTS AND GIVEN MORE THAN 130,000 VACCINES.

4B (Expenses $ 471980304 including grants of $ 0) (Revenue $ 535974132)
ANCILLARY SERVICES INCLUDING LABORATORY, RADIOLOGY, DIALYSIS, SOCIAL SERVICES AND CLINICS (SEE NARRATIVE FROM 4A FOR FURTHER EXPLANATION)

4C (Expenses $ 109210080 including grants of $ 0) (Revenue $ 4877051)
GENERAL SERVICES INCLUDING FOOD SERVICE, ENVIRONMENTAL SERVICES, LAUNDRY AND PLANT.

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 3E
THE SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED AND DOCUMENTED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT.

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 5
HEALTHY CAPITAL COUNTIES FOCUS GROUPS: IN ORDER TO GATHER INFORMATION FROM TRADITIONALLY HARD TO SURVEY POPULATIONS AND TO DOCUMENT THE EXPERIENCES, THOUGHTS, BELIEFS, AND STORIES OF THE COMMUNITY, HEALTHY CAPITAL COUNTIES CONDUCTED A SERIES OF FOCUS GROUPS FOR THE PROJECT. SIX FOCUS GROUPS WERE HELD BETWEEN MARCH AND MAY OF 2018 AND TOOK PLACE IN VARIOUS LOCATIONS THROUGHOUT THE THREE-COUNTY FOCUS AREA (CLINTON, EATON, AND INGHAM COUNTIES). GROUPS THAT WERE ACTIVELY SOLICITED FOR INPUT INCLUDED: - PEOPLE WITH DISABILITIES; - PEOPLE RECOVERED/RECOVERING FROM SUBSTANCE ADDICTION; - PEOPLE WHO DO NOT HAVE HEALTH INSURANCE; - PEOPLE WHO HAVE LOW INCOMES OR ARE UNEMPLOYED; - PEOPLE WHO IDENTIFY AS SPANISH-SPEAKING HISPANIC OR LATINO/A; AND - PEOPLE WHO IDENTIFY AS PERSONS OF COLOR. SPARROW HEALTH SYSTEM FOCUS GROUPS: ON BEHALF OF SPARROW HEALTH SYSTEM, THE MICHIGAN PUBLIC HEALTH INSTITUTE CONDUCTED FOUR ADDITIONAL FOCUS GROUPS TO EXPAND UPON THE INFORMATION GATHERED DURING THE HEALTHY CAPITAL COUNTIES FOCUS GROUPS. FOCUS GROUPS WERE CONDUCTED IN JUNE AND JULY OF 2018, AND TOPICS COVERED INCLUDED RURAL HEALTH AND ACCESS TO CARE. SPARROW HEALTH SYSTEM KEY INFORMANT INTERVIEWS: IN ADDITION TO THE FOCUS GROUPS CONDUCTED ON BEHALF OF SPARROW HEALTH SYSTEM, THE MICHIGAN PUBLIC HEALTH INSTITUTE ALSO SPOKE WITH THIRTEEN PEOPLE WHO PARTICIPATED IN KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS WERE CONDUCTED BY TELEPHONE BETWEEN AUGUST AND SEPTEMBER OF 2018. CAPITAL AREA BEHAVIORAL RISK FACTOR & SOCIAL CAPITAL SURVEY (BRFS): SINCE 2000, THE CAPITAL AREA UNITED WAY, BARRY-EATON DISTRICT HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, AND MID-MICHIGAN DISTRICT HEALTH DEPARTMENT HAVE CONDUCTED A TELEPHONE HEALTH SURVEY OF THE ADULT POPULATION IN THEIR JURISDICTIONS (BARRY, EATON, INGHAM, CLINTON, GRATIOT, AND MONTCALM COUNTIES) ON VARIOUS BEHAVIORS, MEDICAL CONDITIONS, AND PREVENTIVE HEALTH CARE PRACTICES. THE SURVEY WAS CONDUCTED USING THE CAPITAL AREA BEHAVIORAL RISK FACTOR & SOCIAL CAPITAL SURVEY INSTRUMENT, WHICH INCLUDES QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM QUESTIONNAIRE AS WELL AS QUESTIONS DEVELOPED BY THE HEALTH DEPARTMENTS TO COLLECT INFORMATION OF INTEREST TO THE LOCAL COMMUNITY. DURING THE 2014-2016 DATA COLLECTION CYCLE, A TOTAL OF 3,613 ADULTS IN CLINTON, EATON, AND INGHAM COUNTIES RESPONDED TO THE LANDLINE/MOBILE PHONE SURVEY. THE OVERALL SURVEY RESPONSE RATE WAS 32.9%. COMMUNITY AND HEALTH CARE PROVIDER SURVEYS: IN ORDER TO GATHER INPUT ABOUT THE COMMUNITYS HEALTH NEEDS FROM STAKEHOLDERS AND THE GENERAL PUBLIC, TWO ONLINE SURVEYS WERE ADMINISTERED BETWEEN APRIL AND JUNE OF 2018. ONE SURVEY WAS FOR ANY COMMUNITY RESIDENT WHO LIVED AND/OR WORKED IN THE TRI- COUNTY AREA, AND THE SECOND SURVEY WAS FOR HEALTH CARE PROVIDERS ASSOCIATED WITH THE HOSPITAL SYSTEMS PARTICIPATING IN THE HCC COLLABORATIVE.

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 6A
SPARROW HOSPITAL, CONSISTING OF SIX COMMUNITY HOSPITALS, THREE OF WHICH ARE LOCATED IN THE THREE-COUNTY GREATER LANSING REGION: - EDWARD W SPARROW HOSPITAL, LANSING, MI - SPARROW SPECIALTY HOSPITAL, LANSING, MI - SPARROW CLINTON HOSPITAL, ST. JOHNS, MI - SPARROW IONIA HOSPITAL, IONIA, MI - SPARROW CARSON HOSPITAL, CARSON CITY, MI - SPARROW EATON HOSPITAL, CHARLOTTE, MI - MCLAREN GREATER LANSING - EATON RAPIDS MEDICAL CENTER

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 6B
- MICHIGAN PUBLIC HEALTH INSTITUTE - BARRY-EATON DISTRICT HEALTH DEPARTMENT - INGHAM COUNTY HEALTH DEPARTMENT - MID MICHIGAN DISTRICT HEALTH DEPARTMENT

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 11
EDWARD W SPARROW HOSPITAL HAS DEVELOPED AN IMPLEMENTATION STRATEGY FOR THE TOP PRIORITIES THAT WERE IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS. THE TOP NEEDS IDENTIFIED WERE ACCESS TO HEALTH CARE, CHRONIC DISEASE - DIABETES, AND MENTAL HEALTH CARE. FOR EACH OF THE NEEDS IDENTIFIED MULTIPLE KEY OBJECTIVES WERE IDENTIFIED TO CREATE A STRATEGY ON HOW TO MEET THE NEEDS. FOR EACH KEY OBJECTIVE AN IMPLEMENTATION STRATEGY WAS CREATED, INCLUDING TIMING FOR THE IMPLEMENTATION AND GOALS TO MONITOR THE SUCCESS OF MEETING THE NEEDS. OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THIS STRATEGY INCLUDED FINANCIAL STABILITY. THIS HEALTH NEED IS IMPORTANT BUT IT IS NOT WITHIN THE SCOPE OF THE HOSPITAL'S CORE COMPETENCIES.

GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 24
ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.

GROUP A, FACILITY 2, EWSH - ST. LAWRENCE CAMPUS - PART V, LINE 24
ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.

SCHEDULE H, PART I, LINE 7
A COST TO CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B AND 7C). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS (LINE 7E), SUBSIDIZED HEALTH SERVICES (LINE 7G) AND RESEARCH (LINE 7H). IN RESPONSE TO THE COVID-19 PANDEMIC THE HOSPITAL RECEIVED GENERAL AND TARGETED DISTRIBUTIONS UNDER THE CARES ACT PROVER RELIEF FUNDING. THE HOSPITAL MET THE CONDITIONS AND RESTRICTIONS NECESSARY TO RETAIN THE DISTRIBUTIONS ENTIRELY THROUGH A CALCULATION OF LOST REVENUE DURING THE YEAR ENDED 12/31/2021. AS A RESULT, THE PROVIDER RELIEF FUNDING DISTRIBUTIONS RECEIVED BY THE HOSPITAL ARE NOT INCLUDED AS OFFSETTING REVENUE IN THE SCHEDULE H.

SCHEDULE H, PART II
"SPARROW HEALTH SYSTEM'S REACH EXTENDS FAR BEYOND THE ACUTE CARE SETTING OF THE HOSPITAL. THERE ARE MANY WAYS OUR STAFF PROACTIVELY SUPPORTS THE COMMUNITY, ESPECIALLY THOSE WHO HAVE THE GREATEST NEED. WHETHER THROUGH CHARITABLE CARE, SUBSIDIZED HOSPITAL PROGRAMS AND SERVICES, MEDICAL EDUCATION OR COMMUNITY HEALTH EDUCATION, SPARROW STRIVES TO RESPOND TO THE REGION'S MOST PRESSING HEALTH NEEDS. FOR MORE THAN 114 YEARS, SPARROW HAS BEEN DISTINGUISHED BY ITS PASSIONATE COMMITMENT TO CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS WHO MEET CERTAIN QUALIFICATIONS. SPARROW ALSO PROVIDES ""SUBSIDIZED HEALTH SERVICES."" THESE ARE SERVICES THAT ARE OFFERED DESPITE FINANCIAL LOSS BECAUSE THE COMMUNITY NEEDS THEM, BECAUSE OTHER PROVIDERS ARE NOT WILLING TO OFFER THEM, OR BECAUSE THE SERVICES WOULD OTHERWISE NOT BE ABLE TO MEET PATIENT DEMAND. THESE SERVICES INCLUDE HOSPICE AND PALLIATIVE CARE; MENTAL HEALTH SERVICES; NEONATAL INTENSIVE CARE; OBSTETRICS; REHABILITATION; EMERGENCY AND TRAUMA SERVICES; GERIATRICS CLINICS; AND PEDIATRIC CLINICS."

SCHEDULE H, PART III, LINE 2
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE COST TO CHARGE RATIO IS USED IN DETERMINING BAD DEBT INFORMATION.

SCHEDULE H, PART III, LINE 3
IN REVIEWING ACCOUNTS CLASSIFIED AS BAD DEBT, THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3, REFLECTS PATIENTS WHO HAD PREVIOUSLY QUALIFIED FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT, BUT WHO AT THE TIME OF SERVICES, WERE NO LONGER ELIGIBLE FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT OR THE SERVICES PROVIDED WERE NOT COVERED BENEFITS. THE HOSPITAL FURTHER REVIEWED THESE PATIENTS TO MAKE A DETERMINATION OF THE PATIENTS' ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY.

SCHEDULE H, PART III, LINE 4
BAD DEBT FOOTNOTE - SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, IS A RATIO OF COSTS TO CHARGES. THE HOSPITAL BELIEVES THE FULL AMOUNT OF THE SHORTFALL REPORTED ON PART III, SECTION B, LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS AND THAT SHORTFALL OF 62,143,600 SHOULD BE COUNTED AS COMMUNITY BENEFIT.

SCHEDULE H, PART III, LINE 9B
THE CHARGES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE ARE WRITTEN OFF THE SYSTEM TO CHARITY CARE AT THE TIME THE PATIENT'S CHARITY CARE STATUS IS DETERMINED. AS SUCH, NO FURTHER COLLECTION EFFORTS TAKE PLACE.

SCHEDULE H, PART VI, LINE 2
THROUGH CONTINUAL ANALYSIS OF OUR ANNUAL CASE MIX AND COLLABORATION WITH COMMUNITY PARTNERS, SPARROW IS ABLE TO MAKE ACCURATE ASSESSMENTS OF THE HEALTH CARE NEEDS OF THE REGION IT SERVES. FOR EXAMPLE, OUR REGIONAL COLLABORATION OF AREA HEALTH PARTNERS, WHICH INCLUDES SPARROW, MICHIGAN STATE UNIVERSITY, MCLAREN HEALTH CARE, LANSING COMMUNITY COLLEGE, THE MICHIGAN STATE AND INGHAM COUNTY MEDICAL SOCIETIES, THE INGHAM COUNTY HEALTH DEPARTMENT, THE LANSING SCHOOL DISTRICT, THE ACCIDENT FUND, THE CAPITAL AREA HEALTH ALLIANCE AND OTHER ORGANIZATIONS RECENTLY ADOPTED A NEW GOAL OF DEVELOPING THE HEALTH PLAN CHAPTER FOR THE GREATER LANSING NEXT INITIATIVE. ASSESSING THE REGION'S HEALTH CARE NEEDS IS A KEY COMPONENT OF THIS STRATEGIC PLAN WHICH IS FOCUSED ON ECONOMIC DEVELOPMENT FOR THE REGION.

SCHEDULE H, PART VI, LINE 3
SPARROW HOSPITAL EMPLOYS SEVERAL METHODS TO COMMUNICATE ELIGIBILITY FOR ASSISTANCE TO PATIENTS. ALL UNINSURED INPATIENTS ARE DIRECTLY SCREENED FOR POTENTIAL MEDICAID ELIGIBILITY AND ANY OTHER GOVERNMENT PROGRAMS (COBRA BENEFITS, ETC). SIGNAGE IS POSTED IN OUR PATIENT REGISTRATION AREAS REGARDING AVAILABILITY OF SPARROW COMMUNITY FINANCIAL AID (CFA) PROGRAM (CHARITY CARE). ALL PATIENT BILLING STATEMENTS HAVE A NOTE REGARDING THE CFA PROGRAM AND OUR WEBSITE CONTAINS LINKS TO OUR CFA POLICY AND APPLICATION.

SCHEDULE H, PART VI, LINE 4
SPARROW SERVES THE MID-MICHIGAN REGION WHICH CONSISTS OF THE GREATER LANSING AREA (A POPULATION OF APPROXIMATELY 450,000). STRATEGICALLY LOCATED IN THE HEART OF MICHIGAN, SPARROW IS LOCATED WITHIN 90 MINUTES OF 90 PERCENT OF THE STATE'S POPULATION OF APPROXIMATELY 10 MILLION PEOPLE. THE STATE CAPITAL, MICHIGAN STATE UNIVERSITY, AND TWO GENERAL MOTORS ASSEMBLY FACILITIES MAKE THE LANSING REGION AMONG THE MOST STABLE AND DIVERSE ECONOMIES IN MICHIGAN. THE REGION IS EVOLVING AS A LEADING ECONOMIC FORCE IN RESEARCH AND DEVELOPMENT, WAREHOUSING AND DISTRIBUTION, INFORMATION TECHNOLOGY, BIO-TECHNOLOGY, HEALTHCARE, INSURANCE, AND FINANCIAL SERVICES.

SCHEDULE H, PART VI, LINE 5
"AS NOTED ABOVE, THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES. THESE SERVICES ARE PROVIDED UNDER THE MISSION OF THE ORGANIZATION - ""IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME."""

SCHEDULE H, PART VI, LINE 6
EDWARD W SPARROW HOSPITAL IS A WHOLLY-OWNED SUBSIDIARY OF SPARROW HEALTH SYSTEM. SPARROW HEALTH SYSTEM IS A NON-PROFIT, COMMUNITY GOVERNED, INTEGRATED HEALTH DELIVERY SYSTEM SERVING MID-MICHIGAN. SPARROW HEALTH SYSTEM PROVIDES SERVICES TO THE COMMUNITIES IT SERVES THROUGH ITS CONTROLLED SUBSIDIARIES: PHYSICIAN HEALTH PLAN, PHYSICIAN HEALTH NETWORK, EDWARD W SPARROW HOSPITAL, SPARROW CLINTON HOSPITAL, SPARROW SPECIALTY HOSPITAL, SPARROW CARSON HOSPITAL, SPARROW DEVELOPMENT, INC., SPARROW COMMUNITY CARE, INC., SPARROW IONIA HOSPITAL, SPARROW FOUNDATION, SPARROW CLINICAL RESEARCH INSTITUTE, AND SPARROW EATON HOSPITAL.

SCHEDULE H, PART VI, LINE 7
MICHIGAN