Cat. No. 50192T Schedule H Form 990 2016 Page 2 Community Building Activities Complete this table if the organization conducted any community building health of the communities it serves. Attach to Form 990. Information about Schedule H Form 990 and its instructions is at www.irs.gov/form990. SCHEDULE H Form 990 Hospitals OMB No. 1545-0047 Complete if the organization answered Yes on Form 990 Part IV question 20. Department of the Treasury Internal Revenue Service Name of the organization Part I...Open to Public Inspection Employer identification number Financial Assistance and Certain Other Community Benefits at Cost Yes 1a Did the organization have a financial assistance policy during the tax year If No skip to question 6a. b If Yes was it a written policy. If the organization had multiple hospital facilities indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year. No 1a 1b Applied uniformly...to most hospital facilities Generally tailored to individual hospital facilities Answer the following based on the financial assistance eligibility criteria that applied to the largest number of a free care If Yes indicate which of the following was the FPG family income limit for eligibility for free care Other indicate which of the following was the family income limit for eligibility for discounted care. for determining eligibility for free or discounted care. Include in the description...whether the organization used an asset test or other threshold regardless of income as a factor in determining eligibility for free or discounted care. 3a 3b tax year provide for free or discounted care to the medically indigent. b If Yes did the organization s financial assistance expenses exceed the budgeted amount. c If Yes to line 5b as a result of budget considerations was the organization unable to provide free or Complete the following table using the worksheets provided in the Schedule...H instructions. Do not submit these worksheets with the Schedule H. a Number of b Persons c Total community d Direct offsetting e Net community activities or served benefit expense revenue Means-Tested Government Programs programs optional 5a 5b 5c 6a 6b f Percent of total expense Worksheet 1. Medicaid from Worksheet 3 column a b c Costs of other means-tested government programs from Worksheet 3 column b. d Total Financial Assistance and Other Benefits e Community health improvement services and...community benefit operations from Worksheet 4. f Health professions education from Worksheet 5. g Subsidized health services from h i j k Research from Worksheet 7 Cash and in-kind contributions for community benefit from Worksheet 8. Total* Other Benefits. Total* Add lines 7d and 7j. For Paperwork Reduction Act Notice see the Instructions for Form 990. programs Physical improvements and housing Economic development Community support Environmental improvements Leadership development and training...Coalition building Workforce development Total building expense total expense Bad Debt Medicare Collection Practices Section A.
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How to edit IRS 990 - Schedule H
How to fill out IRS 990 - Schedule H
Instructions and Help about IRS 990 - Schedule H
How to edit IRS 990 - Schedule H
To edit IRS 990 - Schedule H, start by obtaining the correct version of the form from the IRS website or a reputable tax forms provider. You can use pdfFiller to upload a digital copy of the form. Utilize the editing tools to make necessary changes, ensuring that information reflects the current financial activities of your organization. Remember to save your changes regularly and review the form for accuracy before submission.
How to fill out IRS 990 - Schedule H
Filling out IRS 990 - Schedule H involves several steps. First, gather your organization’s financial records, including income statements and expense reports. Follow these instructions to complete the form:
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Begin by entering your organization’s name, Employer Identification Number (EIN), and other identifying information in the designated fields.
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Clearly outline the services that your organization provides, focusing on how they support the community, as Schedule H primarily addresses community benefit activities.
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Report all financial information accurately, including revenue, expenditures, and any assets related to the services offered.
After finishing each section, double-check your work to ensure all data is filled out appropriately. Any missing or incorrect information can lead to delays in processing.
About IRS 990 - Schedule H 2016 previous version
What is IRS 990 - Schedule H?
IRS 990 - Schedule H is a form used by tax-exempt hospitals to report on their community benefits and financial assistance programs. This form is part of the larger IRS Form 990, which is filed annually by organizations to provide the IRS with a comprehensive overview of their finances and operational activities.
Who needs the form?
Tax-exempt organizations that operate as hospitals or healthcare facilities must complete IRS 990 - Schedule H if they meet certain revenue thresholds. Specifically, organizations that are classified under 501(c)(3) and provide care must file this schedule along with their annual Form 990 to maintain compliance with IRS regulations.
Components of the form
IRS 990 - Schedule H is divided into several components, each requiring specific financial and operational details. Key sections include:
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Part I: Community Benefit Activities, where hospitals detail services provided to underserved populations.
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Part II: Financial Assistance Policies that describe how hospitals aid patients in financial need.
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Part III: Definitions and reporting of community benefit activities and the costs associated with these services.
Each part must be completed accurately to portray the hospital's commitment to community health effectively.
Is the form accompanied by other forms?
Typically, IRS 990 - Schedule H accompanies Form 990 when filed with the IRS. Depending on your organization’s specific situation, you may also need to include additional schedules or documents that pertain to other operational aspects, such as Schedule A for public charities or Schedule B for contributors.
What is the purpose of this form?
The primary purpose of IRS 990 - Schedule H is to ensure that tax-exempt hospitals maintain their status by demonstrating their commitment to charitable activities. This includes showing how these organizations support their communities through health services and financial assistance to individuals in need.
When am I exempt from filling out this form?
Organizations may be exempt from filing IRS 990 - Schedule H if they have gross receipts under a designated threshold, which is typically below $200,000. Additionally, hospitals that do not provide healthcare services or have a different charity classification may not need to file this schedule. Consult IRS guidelines for specific exemptions.
What are the penalties for not issuing the form?
Failing to file IRS 990 - Schedule H can result in significant penalties. Organizations may face fines of up to $20,000 for each month the form is late. Additionally, not filing the required forms can jeopardize the organization’s tax-exempt status, leading to further financial implications.
What information do you need when you file the form?
Before filing IRS 990 - Schedule H, gather essential documents including a comprehensive list of services provided, financial statements, policies regarding financial assistance, and any relevant community service reports. Accurate record-keeping will simplify the filing process and help avoid errors.
Where do I send the form?
IRS 990 - Schedule H should be submitted to the IRS at the address specified in the form instructions. This address can vary depending on your organization’s location and whether you are filing electronically or via mail. Always confirm the correct submission address from the latest IRS guidelines to ensure timely processing.
FAQ about IRS 990 - Schedule H
What should I do if I realize I've made an error on my filed IRS 990 - Schedule H?
If you discover an error after filing your IRS 990 - Schedule H, you should prepare to submit an amended return. This involves filling out the correct form and indicating that it's an amendment. Keep in mind that amending could draw additional scrutiny, so ensure all corrections are accurate and well-documented.
How can I track the status of my IRS 990 - Schedule H submission?
To verify the receipt and processing of your IRS 990 - Schedule H, you can use the IRS's online tracking system or contact their customer service. Be aware of common e-file rejection codes which can hinder the acceptance of your file. Promptly addressing these codes can help you avoid delays.
What is the appropriate record retention period for IRS 990 - Schedule H?
It's essential to retain records related to your IRS 990 - Schedule H for at least three years after the submission date. These documents should include financial statements, supporting schedules, and any correspondence related to the form. Proper records ensure compliance and facilitate quick responses to any future inquiries.
Are there service fees for e-filing the IRS 990 - Schedule H?
Yes, some e-filing services charge fees for submitting your IRS 990 - Schedule H electronically. These fees can vary based on the provider you choose. It's advisable to compare different options to find a service that meets your needs without incurring excessive costs.
What should I do if I receive an audit notice regarding my IRS 990 - Schedule H?
If you receive an audit notice related to your IRS 990 - Schedule H, it's crucial to respond promptly and prepare the necessary documentation as requested. Stay organized and consult a tax professional if you're unsure how to respond. Thorough preparation can help clarify your position and support your case.
Use this catalog to find any type of IRS forms. We've gathered all of them under this section uncategorized to help you to find a proper form faster. Once you spot it on this list, have a look at the versions and schedules you might need as attachments. All returns are available for 2016 and for previous fiscal years.
