A report from a Berkeley, Calif.-based nonprofit group has shined a light on nonprofit hospitals in California, saying there is no way to discern if the organizations are providing appropriate community benefit.
The Greenlining Institute issued the report titled, "Not-for-Profit Hospitals and Community Benefit: What We Don't Know Can Hurt Us." At issue was whether nonprofit hospitals and health systems in California provide enough community benefit in exchange for their corporate income and property tax exemptions.
The group looked at seven of the largest systems in the state: Kaiser Foundation Hospitals in Oakland, Dignity Health in San Francisco, Sutter Health in Sacramento, St. Joseph Health in Irvine, Adventist Health in Roseville and Sharp HealthCare and Scripps Health, both in San Diego. Using publicly available data and documents, Greenlining Institute analysts found the organizations spent roughly 7.2 percent of their operating budgets, on average, on community benefit. Most of that spending went toward charity care, and little went to programs to improve community health.
Greenlining Institute officials also said it was difficult to form "a clear picture" of what community benefits were actually provided. The group said it asked each system and the California Hospital Association for more information, but their requests were denied.
"America makes a bargain with these hospital companies: If you operate for the public benefit, you can be tax-exempt," said Carla Saporta, Greenlining Institute health policy director and report co-author, in a news release. "But when we delved into the data, we found that the publicly reported information for the largest companies is so opaque and incomplete it's almost like a black box."
The CHA preempted the report's release with a statement. The hospital group said it was "troubled" by the Greenlining Institute's report, saying it relies on "inaccuracies and faulty assumptions to criticize [the community benefit] program that is, in fact, a robust, effective, transparent partnership between the state's not-for-profit hospitals and the communities they serve."
The report contained several recommendations, including legislation to update California's community benefit laws. The CHA also criticized the group's recommendations, saying they "already are standard practice and included in existing law."
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