Nonprofit Hospital Community Benefits
The GAO has issued a report entitled “Nonprofit Hospitals: Variation in Standards and Guidance Limits Comparison of How Hospitals Meet Community Benefit Requirements.” The GAO found that Internal Revenue Service (IRS) standards allow nonprofit hospitals broad latitude to determine the activities that constitute community benefit, and state tax-exempt/nonprofit status rules also vary substantially. While consensus generally exists regarding how charity care, unreimbursed costs of means-tested government health care programs, and certain other activities qualify as community benefit, there is no consensus defining bad debt and unreimbursed Medicare costs as community benefit. This lack of consensus and differences in measuring charity care and unreimbursed government health care program costs lead to substantial differences in the amount of community benefits hospitals report. The GAO recommends that federal and state policymakers and industry groups continue to address the variability in defining and measuring community benefit activities.
