Schedule H Facility Hypothetical

The following hypothetical example is based on an interpretation of the IRS instructions provided for Part V. The hypothetical is followed by an example of how each operating division could be reported.

Assume Charitable Entity ZZ has the following five operating divisions:

  • ZZ Urban Hospital that operates ZZ Memorial Hospital and ZZ General Hospital on a single consolidated license in Large City, California. Both ZZ Memorial Hospital and ZZ General Hospital have emergency rooms that are open 24 hours a day, 7 days a week. ZZ Memorial Hospital has a single contiguous campus with multiple buildings with separate addresses.
  • A Family Practice Residency program in which residents participate in classroom education, practice at the ZZ Urban Medical Foundation, and participate in a surgical rotation program at ZZ General Hospital.
  • XX Community Hospital that operates in Midsize City, California. XX Community Hospital has an emergency room that is open 24 hours a day, 7 days a week. XX Community Hospital has a research facility in the basement lab. XX Community Hospital also has three outpatient departments on its license: a sleep disorders clinic, a neuroscience clinic, and a wound care clinic. The wound care clinic and the neuroscience clinic are both on hospital premises, but the sleep disorders clinic is 3 miles away.
  • YY Remote Hospital operates in a rural area 150 miles away from ZZ Urban Hospital and 200 miles away from XX Community Hospital. YY Remote Hospital is designated as a critical access hospital and has an emergency room that is open 24 hours a day, 7 days a week.
  • ZZ Urban Medical Foundation that operates a physician care center in Large City, California. ZZ Urban Medical Foundation is exempt from licensure as a healthcare facility in the State of California. ZZ Urban Medical Foundation also operates an outpatient laboratory and imaging center.
Assume also that Charitable Entity ZZ owns a 60% interest in a joint venture (taxed as a partnership), that operates JV Children's Research Hospital in the same city block at XX Community Hospital. JV Children's Research Hospital's main focus is clinical research in the area of cancer. JV Children's Research Hospital does not have an emergency room.

The completed Part V for Charitiable Entity ZZ would look like this:



Note: Items listed in the above example are included on the Charitable Entity ZZ licenses.

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