McDermott Will & Emery’s Stephen Bernstein was one of many that took a stab with his “Top 10 health law issues for 2010” article, outlining his thoughts on what the buzz-topics of the year would be. Among many of the obvious subjects, he mentioned a very specific administrative function, which is Schedule H for Form 990 and how it relates to hospitals. He explained it this way:
Tax-exempt hospitals must, for the first time, fully complete Schedule H to Form 990 when filing their 2009 tax returns. Schedule H requests disclosure of each hospital’s community building activities, bad debt expenses, Medicare-shortfall and debt-collection practices, arrangements with management companies, participation in joint ventures, and level of charity care and other community benefits. In addition to these data, Schedule H also requests supplemental information in narrative form, including descriptions of how the hospital assesses the needs of its community, informs patients of their eligibility for charity care, and uses community building activities to promote the health of its service area. While many hospitals used last year’s filings as “practice” for Schedule H’s data portions, few prepared sample responses to its narrative portions.
In addition to learning about the ins-and-outs of Schedule H, tax-exempt hospitals must also fully complete Form 990's Schedule K. Schedule K, which requests additional information on tax-exempt bonds, including disclosure of private business use.
All of this information compiled by Schedule H and Schedule K, because of the way it is being filed, will eventually be subject to public disclosure and the media. While there will be a lag of about a year in being made public, hospitals should be consulting now with outside organizations on how to properly compile this information for the federal government.
While this issue isn’t as heart-pounding as others in healthcare, what can’t be denied is that an economy that is in the midst of recovery, combined with a large-scale healthcare reform, creates a scenario in which every ounce of efficiency has to be identified, and while we are still in the beginning stages of this new process, there is potential to learn a great deal from the information that will now be shared via these new mechanisms. The immediate reaction is to assume that this will be used as source material for negative investigations, but through this process, we may also be able to create an upgraded business model and examples of best practices for hospital administration.