The Financial Management of Hospitals and Healthcare Organizations

Michael Nowicki

Chapter 3

Tax Status of Healthcare Organizations

Taryn D. Davis

June 6, 2007

Outline

Healthcare corporations are granted legal status as corporations by the state. Most hospitals are designated as for-profit or not-for-profit.

·  For-profit corporations pay taxes, including income, sales, and property/real estate tax.

·  Not-for-profit corporations do not pay taxes and are tax-exempt.

Tax-exempt organizations

·  Tax-exempt companies must meet criteria that is established by the federal, state and local governments.

·  Companies are given tax-exempt status to

·  Relieve the government of the burden of providing the services themselves. (to provide to those that cannot afford healthcare)

·  Reward companies for performing services that enhance community values and goals.

To qualify for tax-exempt status:

·  Operate for charitable, scientific, or educational reasons

·  Serve public rather than private sector

·  Agree not to engage in prohibited transactions (political campaign, influencing legislation)

·  Lend income without receiving adequate security and interest

·  Pay compensation in excess of reasonable salary levels

·  Make any investments for more than adequate consideration

·  Sell any asset for less than adequate consideration

·  Diverting part of its income or assets

·  Offer preferential service

Revenue Ruling 69-545 (1969):

·  Hospitals must operate a full-time ER that accepts all patients regardless of whether they can pay

·  Hospitals must provide care for all patients in the community who can pay with private funds or through public programs (Medicare/Medicaid)

Is there a difference between community benefits for not-for-profit vs. for-profit hospitals?

·  Point of debate

·  Claim was initially made in the New England Journal of Medicine

·  Claim stated for-profit hospitals did not provide benefits to the community

·  Little evidence has been found to support the claim

Court reviews of not-for-profit status

·  Courts aim to more closely monitor not-for-profit hospitals to ensure they are meeting the rules

·  Hospitals should provide an amount of charity care that equals the value of local and state tax-exempt benefits received

IRS Challenges to tax-exempt status

·  In 1987, the IRS begin to audit tax-exempt organizations

·  Coordinated Examination program (CEP) – method for identifying organizations to audit

o  Instituted in 1991

o  New audit program consisting of an interdisciplinary team to examine corporate restructuring, pension, payroll taxes, income taxes, and tax exempt bond financing

·  HFMA 1992 – audit guide for tax-exempt hospitals

o  Examined the following:

§  Community benefit standard (who is on government board, how much charity care given, complaints of patient dumping)

§  Unreasonable compensation and private inurement (physician relationships that violate private benefit, compensation, recruiting practices)

§  Financial analysis (unrelated business income, private interest, lobbying activities)

§  Joint ventures (between hospital and physician/radiologist, etc)

§  Independent contractors (should they be contractors or employees?)

Legislative challenges to tax-exempt status

·  Little legislation out there related to tax privileges of tax-exempt organizations at the state or federal level

·  Existing law may be too lenient and difficult to enforce

·  Taxpayer Bill of Rights II – addresses tax-exemption

o  Signed into law in 1996

o  Provides IRS with immediate sanctions prior to revoking tax-exempt status

o  Requires tax-exempt organizations to disclose excess benefit transactions and excise taxes paid for such transactions

o  Subjects individuals (executives) as responsible for excess benefit transaction

·  Individual organizations should pay attention to the legislation coming down at the state and federal levels

o  States (ex. Texas) have passed laws that legally bind not-for-profits to provide a certain amount of community benefits

Terms & Definitions

Patient dumping – denying or transferring patients based on the inability to pay

CEP – coordinated examination program; method for identifying organizations to audit

Excess benefit transaction – any transaction in which payment or benefit exceeds the value of the transaction (ex. Unreasonable compensation)

HFMA 1992 – audit guide for tax-exempt hospitals

Taxpayer Bill of Rights II – addresses tax-exemption

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