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At least 19 recordsLinked to original sources
PubMed1990

The conundrum of charitability: reassessing tax exemption for hospitals.

Tax exemption is an ancient, honorable and expensive tradition. Tax exemption for hospitals is all of these three, but it also places in sharp focus a fundamental problem with tax exemption in general. Organizations can retain their tax exemption while changing circumstances or expectations undermine the rationale that led to the exemption in the first place. Hospitals are perhaps the best example of this problem. The dramatic changes in the health care environment have eliminated most of the characteristics of a hospital that originally persuaded the citizenry to grant it an exemption. Hospitals have entered into competition with tax-paying businesses, and have increasingly behaved like competitive actors. Such conduct may well be beneficial, but it does not follow that tax exemption is appropriate. Rather than an undifferentiated subsidy, a shift to focused goals will provide charitable hospitals with the opportunity and incentive to "do the right thing."

Community Participation↗
PubMed1994

The IRS looks closely at homes for the aging. Organizations must be prepared to face increased scrutiny on tax-exempt status and financing.

Tax-exempt status has long been perceived as appropriate for the traditional retirement home (i.e., congregate housing and life-care facility), which serves the elderly and typically experiences low profit margins. An organization that is both organized and operated exclusively for religious, charitable, scientific, literary, or educational purposes or for testing for public safety may qualify for tax-exempt status under Internal Revenue Code section 501(c)(3). The Internal Revenue Service uses the generic term "homes for the aging" to include all forms of retirement housing facilities (except nursing homes that solely provide the highest level of nursing care). A home for the aging that qualifies under section 501(c)(3) (through satisfaction of the organizational and operational tests) will qualify for charitable status for federal tax purposes if it operates to satisfy the following basic needs of aged persons: suitable housing, healthcare, and financial security. In general, not-for-profit organizations recognized as exempt under code section 501(c)(3) may be eligible for tax-exempt financing to develop a home for the aging through the issuance of tax-exempt bonds. Effective tax-exemption planning is a necessary part of the business planning process by sophisticated not-for-profit organizations that own and operate (or desire to own and operate) charitable homes for the aging and similar housing facilities serving the elderly. The benefits of exempt status remain attractive for many such organizations. The challenge of obtaining and maintaining that status is becoming far more burdensome.

Aged↗
PubMed1993

Deferred compensation for tax-exempt entities.

Many executives in tax-exempt organizations, including healthcare executives, find their tax-advantaged savings opportunities dramatically reduced today compared to previous years. The benefit of employer-sponsored, "qualified" retirement and savings programs has been severely limited by ever-increasing tax restrictions on such plans when they are offered by tax-exempt organizations. And the opportunity for tax-sheltered personal investments has virtually disappeared. One of the last remaining opportunities for tax-advantaged savings in tax-exempt organizations is an employer-sponsored, non-qualified, deferred compensation plan, an option that appears increasingly attractive in light of the recently enacted increased personal tax rates.

Financial Management↗
PubMed1991

Tax-exempt challenges warrant hospitals' attention.

The tax-exempt status of not-for-profit healthcare organizations is being questioned and sometimes challenged on Federal, state, and local fronts. While the Internal Revenue Service (IRS) has created a special program for randomly auditing not-for-profit organizations, Congress is expected to consider legislation that would mandate the amount of charity care and community benefits a tax-exempt hospital must provide in relation to its tax-exemption value. Familiarity with IRS and Congressional activity, as well as with cases in which a hospital's tax-exempt status has been challenged in court, may provide guidelines for hospitals to assess their vulnerability.

Commerce↗
PubMed1999

Ambulatory surgery center joint ventures involving tax-exempt entities.

This article provides an overview of the tax-exempt related issues for ambulatory surgery center joint ventures involving tax-exempt entities. The article analyzes the key points of analysis of the guidance released by the IRS, in particular General Counsel Memorandum 39862, Revenue Ruling 98-15, and Redlands Surgical Services v. Commissioner of the Internal Revenue Service. These key points include whether the venture results in private inurement to insiders and whether the venture furthers the charitable purposes of the tax-exempt entity. The article also provides practical guidance to analyze the documents and structure of the joint venture to ensure compliance with the IRS guidance. These practical considerations include, among other things, whether the charitable purposes of the tax-exempt entity are clearly expressed in the documents and whether the tax-exempt entity has sufficient control over the joint venture to ensure the charitable purposes are being adhered to.

Charities↗
PubMed1982

New tax law hobbles tax-exempt hospitals.

The Economic Recovery Tax Act of 1981 left tax-exempt hospitals at a significant disadvantage in the competition for capital. Although the new law's accelerated depreciation schedules and liberalized investment tax credits contain some marginal benefits for tax-exempt hospitals, these benefits are probably more than offset by the impact of the law on charitable giving.

Capital Financing↗
PubMed1997

Tax-exempt/proprietary partnerships: how the deal gets done.

Joint venture partnerships between tax-exempt healthcare providers and proprietary companies represent a type of provider-sponsored network. Tax-exempt /proprietary partnerships can help tax-exempt providers attain their strategic objectives and, at the same time, retain some governance involvement and healthcare decision-making authority. Proprietary companies that enter into such partnerships are able to expand their market presence and revenue potential without spending capital on an acquisition. Proprietary companies also gain the tax-exempt partners' goodwill, which could take them years to develop on their own. Before negotiating a partnership agreement, potential partners must assess their respective financial, cultural, organizational, and strategic strengths and weaknesses as well as their overall compatibility. Then they must develop contract terms to bring into the partnership negotiations. These terms include purpose, legal structure, assets/liabilities, governance, management, valuation, profit/loss sharing, capitalization/working capital, human resources, withdrawal from the partnership, noncompete covernants, and tax exemption issues.

Capital Financing↗
PubMed1988

Tax exemption: why not-for-profits deserve it.

Not-for-profit healthcare facilities' tax-exempt status is coming under attack, particularly in congressional hearings on the unrelated business income tax. Therefore tax-exempt providers must keep adequate records of all services and expenditures to demonstrate and preserve their exempt nature. A facility qualifies for tax exemption by demonstrating that it is legally organized to achieve its exempt purpose and that the bulk of its activities is directed toward that goal. The exemption indicates an agreement between the government and the facility: The government is willing to forgo collection of the tax due because the facility performs tasks that would otherwise befall the government, in particular, caring for the indigent. In addition to such care, other social goods flowing from tax-exempt healthcare facilities include their responsiveness to the needs of the nation, their desire to benefit the community, the medical training they provide, and their role as outlets for philanthropy. Before great changes are made in the unrelated business income tax, tax-exempt facilities must make legislatures and the public aware of the vital services they provide.

Charities↗
PubMed1988

Property tax exemptions: headed for extinction?

Hospitals face an assault on property tax exemptions that threatens the foundations of all voluntary not-for-profit facilities. The Utah Supreme Court fired the first salvo in this campaign in 1985 in Utah County v. Intermountain Health Care, Inc. The court examined the distinctions between not-for-profit and for-profit hospitals, the extent to which the two hospitals involved were supported by donations and gifts, the "profit" derived from operation, the charges levied on patients, the level of charity care provided, and several other factors before concluding that the hospitals did not qualify as charitable institutions. Since then, efforts at taxing hospitals have grown dramatically. The definition of "charitable" is at the heart of the tax-exemption problem. Charitable is a legal "term of art," which encompasses for more than the simple provision of charity care. The promotion of health is a charitable purpose. Hospitals qualify under the Internal Revenue Code for tax-exempt status because they promote health--not because they provide charity care. Yet all hospitals promote health. What, then, differentiates not-for-profit from for-profit hospitals that justifies a tax exemption? The argument for continued exemption must be made, if at all, on the basis of the community benefit the not-for-profit provides. Charitable institutions exist to serve and benefit the community and to provide an avenue for voluntary association. They help to improve and promote the general welfare through education, religion, and culture. The real benefits of a not-for-profit entity are found in the fulfillment of these concepts.

Charities↗
PubMed1996

Overcoming challenges to tax-exempt status.

The tax-exempt status of not-for-profit healthcare organizations increasingly is being challenged by private, for-profit, investor-owned organizations. Often, the business practices of not-for-profit organizations are virtually indistinguishable from those of for-profit organizations, and not-for-profit organizations sometimes provide less charity and unfunded care than their for-profit competitors. Moreover, the tax subsidies not-for-profit organizations sometimes are used to support activities that compete with those of for-profit organizations. To withstand challenges to their tax status, financial managers in not-for-profit organizations should assume an active role in developing clearly articulated, empirically based information about the extent of community benefit their organizations provide and its value.

Charities↗
PubMed1988

Hospitals face loss of federal tax-exempt status.

Because of governmental challenges, not-for-profit hospitals can no longer take for granted their right to be tax exempt. The Internal Revenue Service is auditing nearly 1,500 tax-exempt healthcare organizations to determine how accurately they are reporting unrelated business income. At greatest risk are those hospital systems that have become overly acquisitive or have strayed from the charitable mission that originally entitled them to tax exemption. To protect their tax-exempt status, currently exempt healthcare institutions must be careful that any activities, such as joint ventures and affiliate corporations, conform to their charitable mission. In the face of tougher legislation and Federal scrutiny, hospitals must make sure they are devoted to and performing a charitable purpose if they want to keep their tax-exempt status.

Charities↗
PubMed1992

Special report on taxation. Court of Appeals denies tax exemption based on "substantial commercial purpose".

When viewed against the background of continuing state and federal legislative efforts to limit the availability of tax-exempt status, the Living Faith case could be seen as yet another indication of difficult times ahead for nonprofit providers. Although it is too early to tell whether this will in fact be the case, tax-exempt providers should be aware of the Living Faith case as perhaps the clearest statement from a federal appeals court in recent years that the operation of an enterprise in too businesslike a manner may make it a taxable activity. Tax-exempt providers that now operate or plan to operate ancillary businesses, whether through joint ventures, wholly-owned subsidiaries, or otherwise, should carefully evaluate such activities against the criteria articulated in Living Faith. This analysis is important not only for purposes of determining whether such activities can qualify for tax-exempt status in and of themselves, but also as an indicator of how such activities might affect the tax-exempt status of the provider.

Christianity↗
PubMed1992

Tax-exempt status and the provision of charity care. Increasing congressional scrutiny.

Tax-exempt status has received considerable attention recently, primarily within the hospital industry. Examination of this issue also is valuable to the home care sector of the health care delivery system. Given the current economic environment, nonprofit organizations are being challenged to justify their tax-exempt status on the local, state, and federal levels. Instances of revocation of real estate tax exemption are becoming increasingly common in the nursing home sector; can the effect on home care be far behind?

Charities↗