Hospital IRS Form 990 Tax Burden

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New Schedules – H and K – for Non-Profits

[By Dr. David Edward Marcinko; MBA, CMP™]dem21

As quarterly premium print-subscribers to Healthcare Organizations [Financial Management Strategies] know, the IRS redesigned Form 990 last year.

Form 990 Burden

The new Form 990 is controversial among not-for-profit hospitals (Schedule H) and tax-exempt bond issuers (Schedule K). Schedule H requires hospitals to provide new information on operations, including community benefit levels, charity care, aggregate bad debt expense, Medicare shortfall information and more.

Input Request

Now, the IRS is asking for healthcare sector input to promote uniform reporting, and make sure the form is simple enough for public use. So, through June 1 of this year, Uncle Sam is accepting comments on Form 990 draft instructions. And, the agency will post all comments on its website.


FORM: IRS Form 990


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2 Responses

  1. More on IRS Form 990

    Did you know that the American Hospital Association [AHA] has filed a letter with the IRS arguing that the agency could do more to accommodate small, cash-strapped institutions in its instructions for filling out the new IRS Form 990 – and accompanying Schedule H – aimed at not-for-profit hospitals? The AHA’s input comes as part of the IRS comment period on the draft instructions, which will remain open until June 1st.

    According to the Wall Street Journal, the AHA raised several concerns in a nine-page letter over core definitions. For example, it cited worries over the agency’s definition of “subsidized services,” which would exclude physician clinics, skilled nursing and ancillary services. The AHA argued that these services can often be part of a non-profit’s charitable mission.

    The AHA also cited several definitions that it considered to be too broad, including “key employee” and “facility,” which would result in healthcare organizations having to engage in onerous amounts of reporting which don’t provide value to the organization itself.

    And so, your thoughts on the matter – especially from tax attorney and CPA subscribers – are appreciated.

    ME-P Staff Reporters


  2. Federal Disproportionate-Share Hospital Cuts Impact on Public Hospitals

    According to the UCLA Center for Health Policy Research, public hospitals in California that serve the poorest patients could face a $1.54 billion funding shortfall in 2019, when federal funding cuts go into effect. California’s safety-net hospitals rely heavily on federal disproportionate-share hospital (DSH) funding, which compensates them for treating the most vulnerable patients. In 2010, DSH funds paid more than half of $2 billion in DSH costs ($1.1 billion) to the 21 safety-net hospitals included in the study, with county and state funds covering the rest.

    But with impending DSH cuts, the the UCLA Center for Health Policy Research estimates payments would drop to roughly $830 million to $980 million and leave hospitals struggling to cover $1.38 billion to $1.54 billion in DSH costs in 2019. As many as 4 million Californians and 30 million Americans nationwide are still likely to be uninsured at that time.

    UCLA Center for Health Policy Research


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