Tuesday, March 16, 2010
The American Hospital Association doesn't like the new Schedule H to form 990, because it . . . well, because it does pretty much exactly what the IRS intended. According the AHA, the Schedule H is fatally flawed because it bases its reporting on EIN's rather than on a system-wide basis. As a result, individual hospitals with individual EIN's report . . . wait for it . . . INDIVIDUALLY! Which according to the AHA means that certain system-wide expenses are "missed" by the 990. In addition, the AHA complains, as usual, that bad debts (e.g., when a hospital bills a poor patient, hounds them with debt collection proceedings and then discovers that, praise be, they really ARE poor!) and Medicare shortfalls (e.g., the difference between what a hospital claims it costs for care vs. government reimbursement - never mind that Medicare reimbursement rates are designed to make care more efficient and squeeze out waste) aren't included in community benefit, nor are "community-building" expenses such as physical improvements in the neighborhood, economic development and workforce development. Which begs the question why hospitals aren't spending their economic development money on, say, care for the poor.