Endangered species? Not-for-profit hospitals face tax-exemption challenge.

The recent decision by the Illinois Department of Revenue to revoke the tax-exempt status of Provena Covenant Medical Center is just one indication of a larger trend in which states are increasingly questioning the exchange of social contributions by not-for-profit hospitals for favorable tax treatment. As yet, there is no consensus on how charity care or community benefits should be measured. Results of a study examining different states' specifications of charity care indicate that alternate definitions of charitable contributions have a material effect on the total dollars recognized as charitable contributions. Such differences could have a bearing on any state's decision regarding whether a hospital should be allowed to retain its tax-exempt status.