IRS Form 990 Schedule H Instructions
This article further explores the following points:
Form 990 Schedule H, Hospitals - Overview
- Updated December 06, 2024 - 8.00 AM - Admin, ExpressTaxExemptForm 990 Schedule H is used by hospital organizations to report information on their charity care, community benefit activities provided by its hospital facilities, and other non-hospital health care facilities that it operated during the tax year and other information related to tax exemption. These hospital facilities also include the ones that operated either directly or through disregarded entities or joint ventures.
Table of Contents
1. Who must file Form 990 Schedule H?
2. Step by Step Instruction on Form 990 Schedule H
Part I - Financial Assistance and Certain Other Community Benefits at Cost
Part II - Community Building Activities
Part III - Bad Debt, Medicare, & Collection Practices
3. Choose ExpressTaxExempt to file your Form 990 with Schedule H
1. Who must file Form 990 Schedule H?
The organization which answered “Yes” on Form 990, Part IV, line 20a, must complete Schedule H and attach it to Form 990.
- Line 20a - Did the organization operate one or more hospital facilities?
Schedule H must be completed by a hospital organization that operated at any time during the tax year at least one hospital facility.
A hospital facility is one that is required to be licensed, registered, or similarly recognized by a state as a hospital.
The organization must file a single Schedule H with Form 990 that combines information from:
1. Hospital facilities that operated directly by the organization and by disregarded entities of which the organization is the sole member.
2. Information about the other healthcare facilities and programs conducted by the hospital organizations or any of the entities mentioned in Line 1.
3. Hospital facilities and other health care facilities, and programs operated by any joint venture which was treated as a partnership, to the extent of the hospital organization's proportionate share of the joint venture.
4. If a group return was filed by the hospital organization, the information on hospital facilities operated directly by members of the group exemption included in the group return must be provided
5. Hospital facilities operated by a disregarded entity of which a member included in the group return is the sole member.
6. Hospital facilities operated by a joint venture that is treated as a partnership to the extent of the group member's proportionate share (determined in the manner described in 3, earlier)
7. Other health care facilities or programs of a member included in the group return even if such programs are provided separately from the hospital's license.
2. Step by Step Instruction on Form 990 Schedule H
Form 990 Schedule H contains six Parts.
- Part I - Financial Assistance and Certain Other Community Benefits at Cost
- Part II - Community Building Activities
- Part III - Bad Debt, Medicare, & Collection Practices
- Part IV - Management Companies and Joint Ventures
- Part V - Facility Information
- Part VI - Supplemental Information
Part I - Financial Assistance and Certain Other Community Benefits at Cost
Organization must provide the following details on Part I:
- Reporting of financial assistance policies
- The availability of community benefit reports
- The cost of financial assistance and other community benefit activities and programs
Most of the lines on Part I of Form 990 Schedule H are “Yes” or “No” Questions.
The few scenarios which needs to be reported on Part I of Form 990 Schedule H:
- If the organization have a financial assistance policy during the tax year and the eligibility criteria that applied to the largest number of the organization’s patients during the tax year
- The organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care
- Did the organization prepare a community benefit report during the tax year
Provide the details for Financial Assistance and Means-Tested Government Programs and Other Community Benefits:
- Number of activities or programs
- Persons served
- Total community benefit expense
- Direct offsetting revenue
- Net community benefit expense
- Percent of total expense
Part II - Community Building Activities
In Part II of the Schedule, report the expenses made in conducting community-building activities for the tax year. The activities conducted by the organization focuses to protect or improve the community's health as well as its safety.
- Number of Activities or Programs
- Persons served
- Total community building expense
- Direct offsetting revenue
- Net community benefit expense
- Percent of total Expense
Part III - Bad Debt, Medicare, & Collection Practices
Most of the lines on Part III of Form 990 Schedule H are “Yes” or “No” Questions.
Section A: Bad Debt Expense
The section requires the following information:
A. report combined bad debt expense of the organization
B.provide an estimated amount of the organization’s bad debt expense made which is attributable to patients eligible under the organization’s financial assistance policy and
C.the method used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit (needs explanation in Part VI)
Section B: Medicare
The section requires the following information:
A. total revenue received from Medicare
B. combine Medicare reimbursements attributable to such costs, and
C. combine Medicare surplus or shortfall.
Section C: Collection Practices
Under this section, report the organization's written debt collection policy for the tax year.
Part IV - Management Companies and Joint Ventures
Part IV of the schedule is used to report information on any management company, joint venture, other separate entity (whether treated as a partnership or a corporation) owned 10% or more by Officers, Directors, Trustees, Key Employees, and Physicians.
In this Part, provide the following information:
- Name of entity
- Description of primary activity of entity
- Organization’s profit % or stock ownership %
- Officers, directors, trustees, or key employees’ profit % or stock ownership %
- Physicians’ profit % or stock ownership %
Part V Facility Information
- Section A - Hospital Facilities
- Section B - Facility Policies and Practices
- Section C - Supplemental Information for Part V, Section B
- Section D - Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
Section A. Hospital Facilities
Report the hospital facilities that the organization operated during the tax year.
Provide info on the name, address, primary website address, and state license number of the hospital facility. If filing as a group return, the name and EIN of the subordinate hospital organization that operates the hospital facilities must be provided.
Section B. Facility Policies and Practices
Section B requires information on a hospital facility by a hospital facility basis. The organization must complete a this section for each of its hospital facilities or facility reporting groups listed in Section A.
Report in this section the Community Health Needs Assessment, Financial Assistance Policy, Billing and Collections, Policy Relating to Emergency Medical Care.
Section C. Supplemental Information for Part V, Section B
In Section C, report the descriptions that are required under Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24.
Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
Under Section D, report information on all the non-hospital health care facilities the organization operates during the tax year. The facilities listed must be from the largest to the smallest in the form.
For every non-hospital health care facility listed, information must be provided on the name, address, and the type of facilities. This includes facilities like rehabilitation and other outpatient clinics, diagnostic centers, mobile clinics, and skilled nursing facilities.
Part VI - Supplemental Information
Part VI is used to provide the detailed explanations required by the following questions, and to supplement responses to other questions on Schedule H (Form 990)
These are the following information that need to be reported:
- Information on the geographic area and demographic constituents of the community served by the organization.
- Eligibility of educated patients and parents for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
- The description of how the organization’s hospital facilities or
- other health care facilities further its exempt purpose by promoting the health of the community.
- Role of the organization and its affiliated health care system.
- State filing of community benefit report
3. Choose ExpressTaxExempt to file your Form 990 with Schedule H
When you file Form 990, the application will automatically generate Schedule H based on the information you provide on the form.
Our Software will validate the information you provide before transmitting to the IRS and allows you to correct the errors if any. This will avoid rejections.
ExpressTaxExempt is an IRS authorized e-file service provider with a track record of providing safe and secure e-filing experience to users.
