Community Benefit

Uncompensated Care Pools

Please Take Note: The information provided does not constitute legal or tax advice. The material is provided for informational/educational purposes only. Please consult with counsel regarding your organization's particular circumstances.

Question: We are confused as to where we should report our bad debt and charity care receipts from the state. Should the receipts be reported as traditional charity care under 'revenue received' to support charity or under Unpaid Costs of Medicaid and Other Public Programs as 'reimbursement and other support'?

Recommendation: The amounts you receive from an uncompensated care pool often are a mix of dollars provided by hospital contributions to the pool and also Medicaid Disproportionate Share Hospital funds. CHA's guidance is to assign the contributions to these pools and the receipts from the pools based on the intent of the legislature that set up the program. If the policy intent was to help hospitals defray the cost of charity care, then the cost of the pool payments and the offsetting revenue should go there. If the intent of the pool was to offset Medicaid losses, then amounts are counted as part of that community benefit. If the policy intent is unclear or "split" between these two purposes, then the revenue can be split between charity care and Medicaid — using the losses as the basis for the allocation. So, if charity care cost is $10 million and the Medicaid losses (before this revenue) are another $10 million, then the pool contributions and receipts get allocated 50/50.

(January 2008)