The following questions are from the 2001 IRS Field Service Advice, and list the features that the IRS considers to make up a factual record on the charitable care policies and activities of a hospital.

  1. Does the hospital have a specific, written plan or policy to provide free or low-cost healthcare services to the poor or indigent?
  2. Under what circumstances may, or has, the hospital deviated from its stated policies on providing free or low-cost healthcare services to the poor or indigent?
  3. Does the hospital broadcast the terms and conditions of its charity care policy to the public?
  4. Does the hospital maintain and operate a full-time emergency room open to all people, regardless of their ability to pay?
  5. What directives or instructions does the hospital provide to ambulance services about bringing poor or indigent patients to its emergency room?
  6. What inpatient, outpatient, and diagnostic services does the hospital actually provide to the poor or indigent for free or for reduced charges?
  7. Under what circumstances does the hospital deny healthcare services to the poor or indigent?
  8. Does the hospital operate with the expectation of receiving full payment from all people to whom it renders services?
  9. How and when does the hospital ascertain whether a patient will be able to pay for the hospital's services?
  10. What documents or agreements does the hospital require poor or indigent patients to sign before receiving care?
  11. What is the hospital's policy on admitting poor or indigent patients as inpatients and outpatients?
  12. Under what circumstances does the hospital refer poor or indigent individuals who require services to other hospitals in the area that admit poor or indigent patients?
  13. Does the hospital maintain separate and detailed records about the number of times, and circumstances under which, it actually provided free or reduced cost care to the poor or indigent?
  14. Does the hospital maintain a separate account on its books that segregates the costs of providing free or reduced-cost care to the poor or indigent? Does this account include any other items, such as write-offs for care to patients who were not poor or indigent?

Source: These questions appeared in P&P Board Issue Analysis 05-01 (April 2005) Appendix A - Creating a Record of Charity Care Policies and Activities

Publication Date: Friday, July 09, 2010

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