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.


INSTRUCTIONS: Click here for the applicable IRS Schedule H instructions.

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