Community Benefit Requirement as a Catalyst for Improving Health Outcomes

Not-for-profit hospitals, report community benefit activities in exchange for tax-exempt status. With a previously loosely defined requirement, activities reported as community came into question. In 2009, the IRS established strict criteria for defining what fulfills the community benefit requirement (CBR). Failure to comply endangers institutions' tax-exempt status. 43 not-for-profit free-standing children's hospitals in the United States were identified to determine which institutions had published community benefit reports prior to the IRS's required date of reporting community benefit activities, in order to determine which hospitals are currently actively involved with community benefit activities. Furthermore, these reports were examined to determine which institutions have gone beyond standard community involvement and have targeted their community-benefit activities towards improving health outcomes and social well-being in their communities. 25/43 (58.1%) of the free-standing not-for-profit children's hospitals in the United States have readily identifiable community benefit reports available for public's viewing, as identified through hospital's website or inquiry phone calls. Fewer than half of these community benefit reports, though, loosely fit the guidelines for an effective community benefit program ,as defined by The National Association of Children's Hospitals and Related Institutions and the Catholic Health Association. Even fewer hospitals have implemented community benefit programs targeted towards improving the health status of their community. A small number of hospitals, however, have done quite a bit to incorporate community benefit into the mission and structure of their institution and can serve as models for how others should evolve. These statistics will likely change with the influence of the IRS' new guidelines and this current data can serve as a frame work for understanding how hospitals have changed their activities based upon this new requirement.