Financial Services-Means-Tested Programs 

Information to complete this screen should be obtained from (or entered by) the Finance Department and completed in accordance with IRS Form 990 Schedule H instructions.

The third tab under Financial Services contains the information for the Means-Tested Programs. 

Government-sponsored health care community benefit includes unpaid costs of public programs, the "shortfall" created when a facility receives payments that are less than costs for caring for public program beneficiaries.  The "payment shortfall" is not the same as a contractual allowance, which is the full difference between charges and government payments. "Means-tested" defines programs where eligibility for benefits or coverage is determined by income or assets.

To Add financial information for Means-tested Programs:
  • Click on the Financial Services Tab
  • Click on the Means-tested Programs Tab
  • Click on the function button Add (far left side of screen)
  • Enter the financial information (as defined below)
  • Click Save 

    You may Edit any record listed in the control panel browse box by highlighting the information record, making your edits, and then clicking on the function button Save.  You may also Delete any record by highlighting it and clicking on the function button Delete.

    Explanation of Financial Services data fields:

    Date
    The date will default to the first day of the current fiscal year.  This may be changed to reflect the period for which you are collecting data, i.e. March 31, for first quarter figures, or December 31 for whole year summary figures, etc.

    Description
    Enter a brief description which clarifies what time period is being covered (limited to 50 alphanumeric characters)

    Persons Served
    Enter the number of people who have received benefits from the Means-Tested Program.  Reporting the number of patient contacts or encounters in accordance with the organization's records is optional for IRS Form 990 Schedule H reporting.  The 2012 Guide for Planning and Reporting Community Benefit recommends using the number of inpatient and outpatient accounts as the number of "persons served" (pg 104).

    Line 1:  Gross patient charges from the programs
    Enter the gross patient charges for the service.  

    Line 2:  Choose a method for figuring expenses (costs)
    (a)  Ratio of patient care cost to charges (enter ratio as a decimal, three places allowed)
       or
    (b)  Estimated costs from cost accounting

    Line 3:  Cost
    The estimated cost will auto calculate based on the method chosen for Line 2.

    Line 4:  Medicaid or provider taxes
    If applicable, enter the dollar amount paid in Medicaid or provider taxes.  See IRS Instructions for "Worksheet 3" for additional information.

    Line 5:  Total Community Benefit Expense
    Line 5 is automatically calculated in accordance with the numerical data entered

    Line 6:  Net patient service revenue
    If applicable, enter the dollar amount for the net patient service revenue.

    Line 7:  Payments from uncompensated care pools or programs
    If applicable, enter the dollar amount for the revenue received from uncompensated care pools or programs.

    Line 8:  Prior year revenue
    If applicable, enter the dollar amount which represents any prior year revenue

    Line 9:  Other revenue
    If applicable, enter the dollar amount which represents any other revenue

    Line 10:  Total direct offsetting revenue
    The total direct offsetting benefit will automatically be calculated by the program and will appear here.

    Line 11:  Net community benefit expense
    The net benefit will automatically be calculated by the program and will appear here.  (NOTE: Per 2015 IRS 990H instructions, negative net community benefit should be reported as "0"; however, the Community Benefit column in the IRS Reconciliation report will continue to show the net negative amount.)

    Restricted Grant Revenue (Optional)
    Enter any offsetting restricted grant revenue dollar amounts in this field.  The amount will be reported on Worksheet 3 but will not be used in calculating net community benefit expense.

    Attach a File
  • To attach an outside file to a Means-Tested record, click on the "Attach a File" link and browse to your document. You may attach up to five files of any type -  including Word, Excel, or PDF - to each Means-Tested record.
  • To remove an attached file from the CBISA record, click on the "garbage can" icon and then save your record.

    See Also:  
    Additional Functionality
    Save Failed: Ambiguous Fiscal Year