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Win/win: urban and rural hospitals network for survival.

In an increasingly competitive, regulated, and politicized environment, the future of small or rural hospitals must rely on an organizational affiliation with an urban multihospital system to optimized opportunities for survival. Development and implementation of a small or rural hospital's affiliation with an urban multihospital system may provide necessary support and strength to survive as an independent entity, avoid mergers and acquisitions from investor-owned systems, and incorporate technical assistance and access to the resources of large, urban "lead" hospitals. Diversification into long-term and alternative care services will provide the foundation for hospital-wide survival through adaptation of alternative delivery plans to both the public and private sectors. Networking, whether through a formal or informal structure, may provide both urban and rural, large and small hospitals, with the only opportunity for survival in the 1980s and beyond. Networking gives hospitals an opportunity to develop symbiotic relationships with previously competing institutions for physicians, services, and patients. Networking solidifies missions, goals, and objectives for healthcare delivery systems and produces a win/win situation for everyone. It may be a legal entity (a corporate structure) or an informal affiliation among like groups of providers. A discussion of networking is provided for consideration by hospitals currently evaluating options in the multihospital systems arena.

Hospital Administration↗

The effects of ownership, system affiliation and corporate unbundling on the performance of hospitals.

The increasing influence of business principles is profoundly altering the health care delivery system. Answered here are the questions: Where should the health field be going? What are the differences between not-for-profit and investor-owned systems? Should hospitals undergo corporate reorganization? and Should a hospital consider a merger or close its doors?

Hospital Administration↗

Public charity status: can the organization pass the test?

To function properly, a parent corporation for a tax-exempt organization, such as a hospital, must obtain public charity status. The parent corporation can qualify as a public charity under one of four basic forms--the most common of which is the supporting organization. A parent corporation qualifies as a supporting organization using one of three tests. Unfortunately, none of these tests completely prove the parent corporation's status, so all must be considered with a careful eye. This article is the second in a three-part series analyzing new and important IRS developments affecting tax-exempt hospitals.

Charities↗