Hospitals should consider a team approach to compiling Schedule H information, perhaps with staff from finance, legal, planning, public relations, and technical services. "If you look at the questions in Schedule H, there isn't going to be one place in any organization that has all the answers," he says. Because rural hospitals may not have the infrastructure for a team approach, Hearle says, it's even more important to get started now. "Often, that 'team' is one person," he says.
Scott Duke, CEO of Glendive Medical Center in eastern Montana, says his 25-bed, acute-care hospital has been gathering community benefit data for more than a decade. He says hospitals that have yet to take the plunge on Schedule H should jump in as soon as they can.
"They can be overwhelmed by these changes and they don't have to be," Duke says. "It takes time to set up the gathering process and incorporate the new changes, but the secret is after that there isn't a lot of work. The real message is that a rural hospital can do this and you don't have to have a fulltime department staff designated to do it."
Duke says the key is to have community benefits indicators set up not only from the financial side of the house, such as charity care, but also with leadership as it develops community benefit-building activities. It also helps to have a good software program—ala TurboTax—that tracks and classifies community benefits.
It's also a question of attitude. Duke says hospitals shouldn't look at Schedule H as an undue burden. "It's actually our sacred responsibility as nonprofit hospitals to tell our story," he says.
Hearle says hospitals should look at Schedule H as an opportunity. "This will allow every hospital to tell the story of the community benefits they provide," he says. "That could be effective in attracting new board members and philanthropy and communicating with all stakeholders that we are effective in the way we are meeting community needs."
"That is an important story to be told these days because the expectation of legislators and others is not abating," Hearle says. "One of the big benefits is slowing down legislative initiatives that would make all of this, shall we say, more taxing."