Schedule H (Form 990), Hospitals, is the Internal Revenue Service (IRS) schedule on which a hospital organization reports the financial assistance, community benefit, billing and collection practices and facility policies of the hospitals it operates. It is completed by organizations that answered “Yes” on Form 990, Part IV, line 20a, and it is attached to Form 990 for the tax year. On FillingPDF you can fill out Schedule H (Form 990) online and download or print the completed PDF; the IRS publishes the form and its instructions at www.irs.gov/Form990.
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What is Schedule H (Form 990)?
Schedule H (Form 990), Hospitals, is the IRS schedule that hospital organizations complete to report the activities, policies and community benefit of the hospital facilities and other health care facilities they operated during the tax year, and attach to Form 990.
The schedule exists because the Affordable Care Act added section 501(r) to the Internal Revenue Code. Section 501(r) sets extra requirements for a hospital organization to qualify for tax exemption under section 501(c)(3): a financial assistance policy (FAP), a policy on emergency medical care, billing and collection limits, limits on charges for medical care, and a community health needs assessment (CHNA) for each hospital facility.
The form has six parts:
- Part I: financial assistance and certain other community benefits at cost, with the table on line 7.
- Part II: community building activities.
- Part III: bad debt, Medicare and collection practices.
- Part IV: management companies and joint ventures owned 10% or more by officers, directors, trustees, key employees and physicians.
- Part V: facility information, in Sections A through D, including a separate Section B for each hospital facility or facility reporting group.
- Part VI: supplemental information.
It is a schedule of Form 990 and is not filed on its own. The IRS instructions also warn that the definition of “hospital” for Schedule A (Form 990), Part I, line 3, is not the same as the one used for Schedule H, so checking that box on Schedule A does not by itself require this schedule.
Who needs to file Schedule H (Form 990)?
An organization that answered “Yes” on Form 990, Part IV, line 20a, must complete Schedule H (Form 990) and attach it to Form 990. In practice that is a hospital organization that operated at least one hospital facility at any time during the tax year. A hospital facility is one required to be licensed, registered or similarly recognized by a state as a hospital; several buildings under a single state license count as one facility.
The organization files one Schedule H that combines information from:
- hospital facilities it operates directly;
- hospital facilities of disregarded entities of which it is the sole member;
- other health care facilities and programs of the organization or those entities;
- joint ventures treated as partnerships, to the extent of its proportionate share;
- for a group return, the members included in that return.
Exclusions and limits stated in the IRS instructions:
- An organization that did not operate a facility meeting the hospital facility definition during the tax year should not file Schedule H.
- Do not report an affiliated entity that is a separate legal entity treated as a corporation, except in Part IV (and except group exemption members in a group return).
- Do not enter information from hospitals outside the United States in Parts I, II, III or V.
An organization not required to file Form 990 that chooses to do so must file a complete return with all required schedules.
When to file Schedule H (Form 990)
Complete Schedule H (Form 990) whenever you file Form 990 for a tax year in which you answered “Yes” on Part IV, line 20a. The schedule prints no separate due date: it is attached to Form 990 and travels with it.
Some timing rules sit inside the questions. Part V, Section B, lines 1 and 2 ask about licensing, or acquisition as a tax-exempt hospital, in the current or the immediately preceding tax year. Line 3 asks whether a CHNA was conducted in the tax year or either of the 2 preceding tax years, and the instructions say each hospital facility must conduct a CHNA at least once every 3 years. On line 12b, answer “Yes” if Form 4720 was filed during the tax year, or after it but before this return was filed.
Check www.irs.gov/Form990 for the due date and extension rules that apply to Form 990 itself.
Documents you need
- Most recent audited financial statements of the hospital organization, attached to Form 990; if only consolidated audited statements exist, attach those with details of consolidation.
- A copy of the hospital facility's most recently adopted implementation strategy, attached to the return, only if it is not posted on a website (Part V, Section B, line 10b).
- Documentation behind Part I, line 7 (Worksheets 1 through 8 or equivalent): not filed with the schedule, but retained by the organization to substantiate the entries.
How to fill out Schedule H (Form 990)
Enter organization name and EIN
At the top of page 1, enter the name of the organization and its employer identification number. Confirm you answered “Yes” on Form 990, Part IV, line 20a.
Answer Part I financial assistance questions
On lines 1a through 5c, say whether you had a financial assistance policy (FAP) and whether it was written, check one box on line 2, and give the federal poverty guidelines limits on lines 3a and 3b. Answer lines 4, 5a, 5b and 5c. Use the policy that applied to the largest number of patients.
Report community benefit report status
On lines 6a and 6b, say whether you prepared a community benefit report during the tax year and whether you made it available to the public. If the answer to line 6a is “No,” skip to line 7.
Complete the Part I, line 7 table
For lines 7a through 7k, enter at cost the number of activities, persons served (optional), total community benefit expense, direct offsetting revenue and net community benefit expense. Enter the percent of total expense in column (f), using the worksheets in the instructions without submitting them.
Fill in Part II community building
For lines 1 through 10, enter the same columns for each community building activity, such as physical improvements and housing or workforce development. Describe in Part VI how these activities promote community health.
Complete Part III, Sections A through C
Section A covers bad debt on lines 1 through 4. Section B covers Medicare revenue, costs, surplus or shortfall on lines 5 through 8, including the costing method box. Section C asks on lines 9a and 9b about a written debt collection policy.
List joint ventures in Part IV
For each management company or joint venture, enter the entity name, its primary activity and the percent of profit or stock owned by the organization, by officers, directors, trustees and key employees, and by physicians in columns (c) through (e).
List hospital facilities in Part V, Section A
Enter the number of hospital facilities operated, then list each from largest to smallest with name, address, website, state license number and the applicable facility type boxes. Assign a facility reporting group letter where several facilities share Section B answers.
Complete a Section B for each facility
Enter the facility name or group letter and its Section A line numbers. Answer the CHNA questions on lines 1 through 12c, FAP lines 13 through 16, billing and collections lines 17 through 20, emergency care line 21, and charges to FAP-eligible individuals on lines 22 through 24.
Add Section C explanations
For each Section B, give the descriptions the form requires for lines such as 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a through 20e, 21c, 21d, 23 and 24. Identify the facility by group letter, line number and name.
List non-hospital facilities in Section D
Enter the number of non-hospital health care facilities operated, then list each from largest to smallest with its name, address and a description of its type.
Complete Part VI supplemental information
Provide the required descriptions on line 1, then lines 2 through 7: needs assessment, patient education about eligibility, community information, promotion of community health, affiliated health care system roles and states where a community benefit report is filed. Identify the part and line each response supports.
Review and download the completed PDF
Check each entry against your worksheets and confirm every required description is in Section C or Part VI. Download or print the completed PDF from FillingPDF and attach it to Form 990 as described under How to submit.
How to submit Schedule H (Form 990)
Schedule H (Form 990) has no filing channel of its own: it is attached to Form 990 and goes wherever that return goes.
- With Form 990: attach the completed schedule, plus any duplicated copies of Part IV, Part V Section A, Section B or D, or Part VI that you needed, to Form 990.
- Audited financial statements: a hospital organization required to file Form 990 must also attach its most recent audited financial statements to Form 990. If it was covered only by consolidated audited statements, it attaches those, including details of consolidation. See the instructions for Form 990, Part IV, line 20b.
- Worksheets: do not submit Worksheets 1 through 8, or equivalent documentation, with the schedule. Keep them to substantiate your entries.
- Instructions and latest information: the form gives no mailing address; go to www.irs.gov/Form990.
The schedule is marked Open to Public Inspection. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Submitting Worksheets 1 through 8 with the schedule; the form says not to submit them, and the instructions say to retain them instead.
- Entering negative numbers in Part I, line 7, columns (e) and (f); if net community benefit expense is less than zero, enter “0” in both.
- Including bad debt in the Part I, line 7 amounts; bad debt is entered in Part III.
- Entering contributions restricted in writing to a community benefit activity on lines 7a through 7h instead of line 7i.
- Filing one Part V, Section B for facilities whose checkbox answers differ; each hospital facility or facility reporting group needs its own Section B.
- Completing Part V, Section B for non-hospital facilities; list them in Section D only.
- Reporting hospitals located outside the United States in Parts I, II, III or V; foreign joint ventures go in Part IV and foreign facilities may be described in Part VI.
- Marking a 250% federal poverty guidelines limit on line 3a in a preprinted box; check “Other” and enter “250%”.
- Leaving out the Part VI descriptions the form requires for Part I, lines 3c, 6a and 7; Part II; and Part III, lines 2, 3, 4, 8 and 9b.
Frequently asked questions
What is Schedule H (Form 990) used for?
Schedule H (Form 990), Hospitals, is used by hospital organizations to report the activities, policies and community benefit of their hospital facilities and other health care facilities. It covers financial assistance, community building, bad debt, Medicare, collection practices, joint ventures and facility policies under section 501(r).
Who has to file Schedule H (Form 990)?
Any organization that answered “Yes” on Form 990, Part IV, line 20a. The IRS instructions say it must be completed by a hospital organization that operated at least one hospital facility at any time during the tax year. An organization that operated no such facility should not file it.
Does Schedule H have its own due date?
No. The schedule prints no separate deadline: you attach it to Form 990, so it is filed with that return for the same tax year. Check www.irs.gov/Form990 for the instructions and latest information on the return itself.
Can I fill out Schedule H (Form 990) online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the schedule with the IRS; you attach it to Form 990 and submit that return through the IRS channels.
Do I send the worksheets with Schedule H?
No. The form says to complete the Part I, line 7 table using the worksheets in the instructions but not to submit them with Schedule H. The instructions say to keep the worksheets, or equivalent documentation, to substantiate the information you entered.
How many Part V, Section B pages do I need?
One for each hospital facility, or one for each facility reporting group. If you can check the same boxes for every Section B question for several facilities, you may file a single Section B and Section C for that group and assign it a letter, A for the largest group.
Which facilities go in Part V, Section D?
Non-hospital health care facilities you operated during the tax year, whether or not state law required them to be licensed or registered. The instructions give rehabilitation and other outpatient clinics, diagnostic centers, mobile clinics and skilled nursing facilities as examples. Do not complete Section B for them.
How do I report a 250% federal poverty guidelines limit on line 3a?
Check “Yes” on line 3a, then check the box marked “Other” and enter “250%”. The instructions use this exact case: when family or household income must be at or below 250% of the federal poverty guidelines to qualify for free care, you use the Other box.
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