Across the country, not-for-profit hospitals are being subjected to unprecedented scrutiny. From local school boards to the Internal Revenue Service, government entities are challenging tax-exempt status. Some financially pressed states and cities are eyeing these hospitals as sources of additional revenue. Other entities want to see tax policy drive social policy by promoting more charity care. Tax-exempt status also is under fire from consumers and legislators. In the wake of the competitive '80s, many people perceive non-profit hospitals as behaving more like businesses than charities. Or, as attorney Brian W. FitzSimons recently wrote in Trustee, they suspect "the fund-raising tail is wagging the medical care dog." The standards for granting tax-exempt status have come under intense examination from all levels. Congress, the IRS, consumers, state legislators and judges, local tax authorities, the Texas attorney general and non-profit hospitals themselves have all joined in the debate.
