Question: Can we count the expense the hospital incurs when the hospital discharges an uninsured patient to another facility and pays for that person's care in an outside facility?
Recommendation: We recommend reporting payments to care for a patient in another setting or facility other than the hospital in the category of "Community Health Improvement A3," as long as your primary purpose in paying for the services is to provide access to the appropriate level of care for persons who meet your documented eligibility requirements, which include medical necessity and financial need.
If, however, the primary purpose is to shorten the patient's length of stay in order to save money for the hospital, we recommend that you do not report the expense as community benefit. Schedule H instructions note, "Don't report as cash or in-kind contributions any payments that the organization makes in exchange for a service, facility, or product, or that the organization makes primarily to obtain an economic or physical benefit."
We recommend that you document this as a program, the intentions of the program and include all the eligibility criteria, including medical necessity and established financial need.
(Updated July 2024)