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| Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low income individuals? (Part I, line 3a) |
| This question and its instructions would benefit from further clarification by the IRS. |
| DISCUSSION: If your hospitals use the Federal Poverty Guidelines (FPGs) as the basis for determining patient eligibility for free care, you will need to answer this question. |
| If you have more than one hospital filing under this Schedule H or your hospital does not consistently use the same FPG, you will need to do a calculation to determine which FPG level applies to the most patients. |
| Here is a simplified sample calculation to guide you: |
| Hospital | FPG Level | # of Patients Receiving Free Care | |
| Mercy | 100% | 100 | |
| Neighborhood | 100% | 100 | |
| Nearby | 150% | 150 |
| Result: Since 200 patients received free care at 100% FPG and 150 patients received free care at 150%, the hospital would check the 100% box. |
| To determine the number of patients, the instructions say to use "contacts" or "encounters." While neither term is defined, it allows hospitals to count each time a patient is served. So, if the same patient is served 3 times at the hospital and provided with free care each time, the number of contacts or encounters would be 3. |
| NARRATIVE REQUIRED: No |
| INSTRUCTIONS: Click here for the applicable IRS Schedule H instructions. |