Income tax and capital gains tax. 10. Surtax; special charge; deeds of covenant to charities; charities.
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Charities↗
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Ochsner/Sisters of Charity launches Total Health 65. Ochsner-Sisters of Charity Health Plan, Metairie, LA.
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Aged↗
[Metal charity counters of charity-box takings].
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Emblems and Insignia↗
Reporting charity care. Hospitals must prepare to comply with new AICPA accounting rules.
To comply with new accounting rules issued by the American Institute of Certified Public Accountants (AICPA), hospitals will have to change the way they report charity care in the financial statements they prepare for fiscal years ending mid-July 1991 and later. In the past, those hospitals which did report charity care information usually lumped it with bad debts under a caption such as "uncompensated services" or disclosed a specific amount of charity care to comply with Hill-Burton or other governmental programs. From now on, however, providers' financial statements must distinguish bad debt from charity care, not report gross patient revenues in the income statement, not imply that charity services generate revenue or receivables, make specific disclosures about the level of charity care provided, and report bad debts as an expense, rather than as a deduction from revenue. Distinguishing bad debts from charity care will be difficult. The AICPA defines bad debts as actual or expected uncollectibles resulting from an extension of credit, and charity care as services for which the provider does not expect payment. The AICPA believes that facilities which establish a definitive management policy on charity care should be able to distinguish between the two. To collect the data necessary to meet the AICPA requirements, hospitals need to establish a method to catalog the charity services they provide. Facilities should also ensure that patients and staff are familiar with their charity care policies.
Accounting↗
A systematic method of accountability. Sound policies allow facilities to account for the level of charity care they provide.
Charity care policies can help hospitals accurately determine, define, and account for the level of charity care they provide. This information will help hospitals budget appropriately and measure trends that will ultimately affect the organization's viability. State governments, the federal government, and the Internal Revenue Service are more closely scrutinizing not-for-profit hospitals' tax-exempt status. As a result, the American Institute of Certified Public Accountants (AICPA) has revised its requirement to report on charity care. To meet the AICPA's requirement, healthcare providers must develop their own definition of charity and determine criteria for providing care free or at a reduced rate. Setting policies to support the organization's definition of charity is necessary for the development of internal systems that promote the early identification of individuals seeking healthcare who will be unable to pay for services. Several policy implications may result from the facility's charity care determination process. For example, patients exhibiting extreme hardship might still be eligible to receive charity care even though their income and assets exceed the hospital's income guidelines. An organization planning to develop a charity care policy must first thoroughly assess its current charity care practices and cost accounting capabilities. Obtaining input from all the departments involved in the development of the charity care policy is necessary to make the transition as smooth as possible.
Budgets↗
Managed care and physicians' provision of charity care.
CONTEXT: Health system changes may be affecting the ability of physicians to provide care with little or no compensation from patients who are uninsured and under-insured and may result in decreased access to physicians for uninsured persons. OBJECTIVE: To examine the association between managed care and physicians' provision of charity care. DESIGN: The 1996-1997 Community Tracking Study physician survey. SETTING AND PARTICIPANTS: A nationally representative sample of 10881 physicians from 60 randomly selected communities. MAIN OUTCOME MEASURE: The number of hours in the month prior to the interview that the physician provided care for free or at reduced fees because of the financial need of the patient. RESULTS: Overall, 77.3% of respondents provided an average of 10.3 hours of charity care per month [corrected]. Physicians who derive at least 85% of their practice revenue from managed care plans were considerably less likely to provide charity care and spend fewer hours providing charity care than physicians with little involvement in managed care plans (P = .01). In addition, physicians who practice in areas with high managed care penetration provided fewer hours of charity care than physicians in other areas, regardless of their own level of involvement with managed care (P<.01). Differences in charity care provision were also shown for other important factors, including ownership of the practice and practice arrangements (more charity care occurred in solo and 2-physician practices; P<.01). CONCLUSION: Physicians involved with managed care plans and those who practice in areas with high managed care penetration tend to provide less charity care.
Charities↗
Healthcare Financial Management Association, Principles and Practices Board. Statement no. 15: Valuation and financial statement presentation of charity service and bad debts by institutional healthcare providers.
Principles and Practices Board (P&P Board) Statement No. 2, issued in 1978, provided a basis for differentiating between charity service and bad debts. The statement acknowledged that, while the differentiation was helpful, the financial accounting and reporting of charity service and bad debts were the same. In 1990, the American Institute of Certified Public Accountants (AICPA) published (after review and approval by the Financial Accounting Standards Board and the Governmental Accounting Standards Board) an extensive revision of the guide titled "Audits of Providers of Health Care Services." The revised guide substantially changed the reporting of bad debts and eliminated charity service from revenue. Disclosure of the entity's policy for providing charity service and the level of charity service provided is required by the revised guide. The P&P Board decided that a substantive revision of its Statement No. 2 was required to bring it into conformity with the revised guide and to provide direction on implementation of the revised guide's requirements. This statement supersedes Statement No. 2 and deals with the same issues, including bad debts.
Accounting↗
Charity care: are hospitals giving their fair share?
How much are hospitals spending on charity care? Overall, they spend far less of their money--about 1% to 2% of annual revenues--on true charity-care cases than the industry would like everyone to believe. The debate over charity care has been muddied by inconsistent definitions of charity care, conflicting requirements from government agencies and misleading data from hospitals.
American Hospital Association↗
Factors affecting charity care and bad debt charges in Washington hospitals.
Uncompensated care has become a major issue in hospital finance as the number of uninsured persons has increased and hospital revenues have declined. Uncompensated care charges have two components--charity care and bad debt--that are distinct conceptually but often are commingled in hospital accounting practice. Data on charges assigned to charity care and bad debt in 1987 for 82 short-stay hospitals in Washington were merged with data from the 1987 Medicare Cost Report and AHA Annual Survey. The regression analyses performed indicate that the determinants of the percent of charges for charity care, bad debt, and total uncompensated care differ and suggest that bad debt should be isolated from charity care when estimating a hospital's level of effort in providing care to indigent patients.
Accounts Payable and Receivable↗
Report of the Special Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care.
Texas not-for-profit hospitals recently received intense scrutiny regarding their involvement in charity-related contributions when Texas Attorney General Jim Mattox formed the Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care. This article details the task force's recommendations concerning charity care obligations of Texas not-for-profit hospitals. Setting the stage for these recommendations was a broad definition of charitable services that included costs for delivering services to indigents and for providing community services to fulfill the hospital's charitable, religious, educational, research, or eleemosynary purposes. The task force unanimously agreed that a mandated level of charity care was incongruent with the hospitals' individual missions and specific community needs, but they supported the formation of standard accounting procedures for charitable services and the voluntary submission of their mission statements to the attorney general of Texas. While the hospitals' role in providing charitable services is very important, the task force emphasized that the overall need for adequate financing and reimbursement of health care is a societal problem that needs specific state and federal actions.
Accounting↗
Empathy, effectiveness and donations to charity: social psychology's contribution.
Charity organizations often use mailed requests to solicit donations from the public. This is not an efficient way to raise large amounts of money. The challenge addressed in this study was to use social psychology's knowledge of helping processes to make mailed requests more effective. Two constructs were identified as possibly useful: empathy and perceived effectiveness of helping. These were manipulated in a field experiment in a 2 x 2 x 2 factorial design (two levels of empathy, two of need extent, and two of need persistence--the last two factors operationalized perceived effectiveness). Letter soliciting donations to a well-known charity were mailed to a random sample of 2648 people in Perth, Western Australia. Manipulations of the three variables were embedded in the letters. The two effectiveness manipulations produced significant main effects, whereas the empathy manipulation was ineffective. We argue that social psychology's knowledge of helping processes is too confined to narrow, theoretical, laboratory-based phenomena to be directly and immediately applicable to the practices of charities.
Charities↗
Fundraising, government grants and donations to nonprofit hospital charities.
Using 1982-1987 tax return data from California hospital charities, this paper investigates the relationship between fundraising expenditures, government grants and donations, during a time in which significant changes were being made in the system of hospital reimbursement. Empirical results suggest that while donations have been declining, charities have been efficient in their solicitation of donations. Results also suggest that government grants worked to reduce charitable contributions in the period before the institution of Medicare's Prospective Payment System. In more recent years, government grants have been associated with increases in donations to hospital charities.
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The supply of charity services by nonprofit hospitals: motives and market structure.
This article studies provision of charity care by private, nonprofit hospitals. We demonstrate that in the absence of large positive income effects on charity care supply, convex preferences for the nonprofit hospital imply crowding out by other private or government hospitals. Extending our model to include impure altruism (rivalry) provides a possible explanation for the previously reported empirical result that both crowding out and income effects on indigent care supply are often weak or insignificant. Empirical analysis of data for hospitals in Maryland provides evidence of rivalry on the supply of charity care.
Altruism↗
Do UK charities have a lot to learn?
This article discusses the key findings of some recent research carried out into the application of market segmentation in the UK charity sector. 410 of the top performing charities (as ranked by income from voluntary donations) were surveyed to profile their major donor groups. Respondents were also asked to indicate how this data was used for fund-raising purposes both in terms of new donor recruitment and existing donor development. The findings show that with the exception of a very few large organizations, the UK charity sector still has much room for improving the sophistication of its fund-raising techniques.
Charities↗
Paying physicians for charity care.
The Internal Revenue Service's (IRS's) Announcement 95-25 gives important new legal support to the practice of compensating physicians for providing charity care. The announcement describes a situation in which tax-exempt hospitals may compensate non-employee physicians who are members of their staffs for providing charity care--a practice that in the past has had only indirect legal support. Before creating arrangements to compensate physicians for charity care, however, healthcare executives first must establish guidelines that ensure the arrangements comply with IRS rules and Federal antikickback laws. Careful planning on the part of healthcare executives can ensure that an important community service is provided without jeopardizing the hospital's tax-exempt status or exposing it to monetary penalties.
Charities↗
Viability and release of Salmonella charity and Escherichia coli from oyster feces.
Sydney Rock oysters (Crassostrea commercialis) contaminated with Salmonella charity and Escherichia coli produced feces containing viable cells of these species. The level of these bacteria in the feces depended upon the level of oyster contamination. Both S. charity and E. coli were released from the feces into overlying seawater. The extent of release into seawater depended upon the physical state of the fecal material, water temperature, and the time of contact with the water. The viability of S. charity and E. coli associated with the feces and released into seawater decreased with time and was a function of seawater temperature. The association and release of bacteria from oyster feces has important implications in oyster purification and purification tank design and may lead to a recontamination of purified oysters.
Animals↗
New rules affect bad debt, charity care reporting.
Many healthcare organizations must change the way they report patient service revenue, following provisions in the American Institute of Certified Public Accountants' recently revised healthcare audit guide. The guide directs that bad debts should be reported as expenses and that charity care should be excluded from revenue and accounts receivable. As a result, hospital executives must ensure that criteria for differentiating charity care from bad debts are in place, understood, and properly carried out.
Accounting↗
A proposal to redistribute the cost of hospital charity care.
Policy analysts debate whether providers of hospital services should share the responsibility of financing care for those who cannot pay for it. Many nonprofit and public hospitals, meanwhile, find it necessary to fund some of the services they deliver. A proposal to redistribute the costs of charity care more equitably is offered, taking into account the benefits an institution receives and its ability to pay. Hospitals would be required to quantify the charity care they provide and to make this information publicly available; in reviewing the information, legislatures are encouraged to set priorities on how much unmet need each state and each hospital should finance.
Charities↗