An Empirical Investigation of For-Profit and Tax-Exempt Nonprofit Hospitals Engaged in Joint Ventures

2004 ◽  
Vol 29 (4) ◽  
pp. 284-290
Author(s):  
Pamela C. Smith
Keyword(s):  
Joint Ventures ◽  
Empirical Investigation ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Tax Exempt

An Examination of Joint Ventures between Nonprofit Hospitals and For-Profit Businesses

2003 ◽  
Vol 1 (1) ◽  
pp. 41-53 ◽  
Author(s):  
Kent Swift
Keyword(s):  
Board Of Directors ◽  
Joint Ventures ◽  
Joint Venture ◽  
Court Cases ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Tax Exempt

Nonprofit hospitals have increasingly found that it is to their advantage to enter into joint ventures with for-profit entities as a means of raising capital and/or obtaining expertise. A number of IRS letter rulings, revenue rulings, and court cases have addressed the issue of the types of joint ventures between nonprofit hospitals and for-profit entities that are within the hospital's charitable mission and those joint ventures that cross the line and would cause the hospital to lose its status as a tax-exempt entity under I.R.C. §501(c)(3). An examination of this literature suggests that nonprofit hospitals can avoid jeopardizing their charitable status when entering into joint ventures with for-profit entities by (1) requiring the joint venture operating entity to provide care to a broad segment of the community; (2) maintaining control over the joint venture, preferably by controlling a majority of the positions on the operating entity's board of directors; and (3) crafting joint venture agreements such that they place primary importance on the venture's charitable mission.

The Conversion Conundrum: The State and Federal Response to Hospitals’ Changes in Charitable Status

1997 ◽  
Vol 23 (2-3) ◽  
pp. 221-250
Author(s):  
Lawrence E. Singer
Keyword(s):  
Joint Venture ◽  
Low Cost ◽  
State Level ◽  
The State ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Tax Exempt ◽  
Federal Response ◽  
Profit Status ◽  
Hospital Conversions

The pressures encountered by hospitals in the current era of reimbursement declines and stiffened competition are well known. As the “ultimate” payors—primarily employers and government—aggressively continue to seek low cost care, the response of the hospital industry has been to move toward consolidation and efficiency-enhancing mechanisms.Increasingly, nonprofit, tax-exempt hospitals have come to believe that they are at a significant disadvantage vis-á-vis their for-profit brethren in their ability to attract the capital needed to compete in the market. A growing trend among nonprofit hospitals, therefore, is to sell to or enter into a joint venture with a proprietary organization, or alternatively to convert to for-profit status. In 1995, fifty-eight nonprofit hospitals became for-profit; hospital conversions to for-profit status in 1996 are projected to outstrip the pace established the prior year.The conversion trend has not gone unnoticed at the state level. Recently, several states have proposed or enacted laws regulating sales and conversions of nonprofit hospitals, and many more states are contemplating such legislation.

Corporate Reorganization: The Last Gasp or Last Clear Chance for The Tax-Exempt, Nonprofit Hospital?

1988 ◽  
Vol 13 (4) ◽  
pp. 527-559
Author(s):  
Melvin Horwitz
Keyword(s):  
Health Care ◽  
Health Care Organization ◽  
Care Organization ◽  
Nonprofit Hospitals ◽  
Corporate Reorganization ◽  
For Profit ◽  
Not For Profit ◽  
Tax Exempt ◽  
Pros And Cons ◽  
Nonprofit Hospital

AbstractThe current revolution in health care organization and financing, increased competition, and a retrenching of industry from its commitments to expansion of health care benefits challenge the nonprofit hospital's existence as a viable entity. Hospital governing boards and administrators have turned to corporate reorganization in order to maintain their financial position and to continue to serve their communities.This Article examines the not-for-profit concept and the problems facing nonprofit hospitals. It reviews the pros and cons of reorganization and the for-profit/nonprofit controversy. It questions whether the hybridization of the hospital results in a stronger or weaker species and discusses the possible effects of the newly structured entity on the quality and delivery of health care. Finally, the Article suggests that the nonprofit hospital may survive only by a continued commitment to societal and communal values, to service rather than to profit; that this commitment is adequate justificaton for the preservation of the nonprofit system, and its preservation will reinforce and strengthen the concept.

Financial Incentives and Competitive Pressure: The Case of the Hospital Industry

2021 ◽  
Author(s):  
Philippe Choné ◽  
Lionel Wilner
Keyword(s):  
Financial Incentives ◽  
Regulatory Reform ◽  
Hospital Industry ◽  
Competitive Pressure ◽  
Nonprofit Hospitals ◽  
For Profit ◽  
Industry Level ◽  
Market Shares

Abstract In the late 2000s, a regulatory reform dramatically strengthened the incentives of French nonprofit hospitals to attract patients. Exploiting exhaustive data for surgery treatments between 2005 and 2008, and modeling hospitals as supplying utility to patients, we show that increased competitive pressure on nonprofit hospitals caused them to perform more procedures, but did not inflate overall activity at the industry level. Although they have gained market shares over their for-profit counterparts, nonprofit hospitals have been significantly worse off after the reform. To adjust to stronger financial incentives, they incurred an additional effort (pecuniary and non-pecuniary costs) equivalent to about a quarter of their annual revenue.

Joint Ventures versus Contractual Agreements: An Empirical Investigation

2006 ◽  
Vol 9 (3) ◽  
pp. 159-175 ◽  
Author(s):  
Stefano Comino ◽  
Petr Mariel ◽  
Joel Sandonís
Keyword(s):  
Joint Ventures ◽  
Empirical Investigation ◽  
Contractual Agreements

The Effects of Not-for-Profit Hospital Reported Profits and Charitable Care on Perceptions of Tax-Exempt Status

2001 ◽  
Vol 23 (2) ◽  
pp. 50-58 ◽  
Author(s):  
Kathryn J. Jervis Wilkicki
Keyword(s):  
Local Property ◽  
Two Dimensions ◽  
Accounting Firms ◽  
For Profit ◽  
Not For Profit ◽  
Tax Practitioners ◽  
State Income Tax ◽  
Tax Exempt ◽  
State Income ◽  
Main Effects

I investigate whether the hospital tax-exemption decision is a function of (1) reported profits and (2) the amount of charitable care provided. Tax practitioners from public accounting firms made decisions about whether the hospital should maintain federal and state income tax and local property tax exemptions. A between-subject design was used with cases at two dimensions: reported profits (high and low) and level of charitable care (high and low). Findings revealed that the main effects of reported profits and charitable care do not independently appear to affect respondents' perceptions about tax exemption. However, when charitable care is low, respondents' perceptions about tax exemption were negatively influenced by high reported profits.

The Evolution of Charity Care within the Healthcare Industry

2006 ◽  
Vol 4 (1) ◽  
pp. 101-116 ◽  
Author(s):  
Pamela C. Smith ◽  
Aaron D. Crabtree
Keyword(s):  
Charity Care ◽  
Nonprofit Hospitals ◽  
Tax Exempt ◽  
Long Time ◽  
State And Local ◽  
To Come ◽  
Definition Of ◽  
State Examination ◽  
Concise Definition

Tax-exempt classification of nonprofit hospitals has been increasingly subject to federal and state examination. Considering the benefits tax-exempt entities receive, it should not be surprising that these organizations face heavy regulatory scrutiny. The problem for tax-exempt hospitals is the lack of a clear and concise definition of charity care in order to maintain exempt status. State and local regulations aside, the IRS has not presented a consistent position regarding standards for nonprofit hospitals. This paper examines the evolution of hospital tax-exempt status and its relationship to charity care. Given the IRS's evolving and conflicting definitions of charity care, we can expect this issue to be debated for a long time to come.

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