/ en Sun, 27 Apr 2025 12:01:07 -0500 Wed, 06 Nov 24 16:00:00 -0600 /legal-documents/2024-11-06-american-hospital-association-2023-irs-form-990 <div class="container"><div class="row"><div class="col-md-8"><h2 class="text-align-left">Public Disclosure Copy</h2><h3 class="text-align-left">黑料正能量 Association IRS Form 990</h3><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/11/2023-AHA-Form-990-Public-Disclosure-Copy.pdf" target="_blank" title="黑料正能量 Association 2023 IRS Form 990 Public Disclosure Copy PDF">Download the Complete AHA 2023 IRS Form 990</a></div></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title">AHA IRS Form 990 from Previous Year</h3></div><div class="panel-body"><ul><li><a href="/system/files/media/file/2023/11/American-Hospital-Association-2022-IRS-Form-990.pdf">2022</a></li></ul></div></div></div></div><div class="row"><div class="col-md-8"><p> </p></div></div></div> Wed, 06 Nov 2024 16:00:00 -0600 Not-for-profit /guidesreports/2023-04-19-essential-role-financial-reserves-not-profit-healthcare <div class="container"> <div class="row"> <div class="col-md-8"> <h2>Introduction</h2> <p>Anyone unfamiliar with the financial structure of not-for-profit hospitals and health systems may question why these organizations carry often significant financial reserves on their balance sheets. The answer is straightforward: with limited sources of funding, hospitals and health systems rely on financial reserves to maintain their financial stability and support their growth. These reserves ensure that hospitals and health systems can continue to serve their communities through good times and bad and can continue to invest in the highly skilled professionals and lifesaving technologies that define modern healthcare.</p> <p>Not-for-profit hospitals and health systems have essentially two sources of funding: they either earn revenue from operations and investments (providing patient services makes up most of this revenue) or they borrow funds through issuance of debt in the bond markets or other forms of borrowing (e.g., bank lines of credit).<sup><a href="#fn1">1</a></sup> Unlike for-profit organizations, they do not have access to equity markets. Also, unlike for-profit organizations, they are not obligated to shareholders who expect that excess funds will be distributed as dividends. Instead, not-for-profit hospitals and health systems have an obligation to their mission and the communities they serve, and strong financial reserves help ensure that they can meet this obligation even in times of operational disruption and financial distress.</p> <p>The importance of financial reserves was demonstrated over the course of 2022, when year-to-date median operating margins for not-for-profit hospitals and health systems remained in negative territory throughout the year (<a href="#figure1">Figure 1</a>). This means that more than half of the hospitals providing data for Kaufman Hall鈥檚 monthly <a href="https://www.kaufmanhall.com/insights/research-report/national-hospital-flash-report-february-2023" target="_blank" title="Kaufman Hall: National Hospital Flash Report: February 2023">National Hospital Flash Report</a> ended the year with negative operating margins, and have not seen an improvement as they move into 2023. Net losses in 2022 for some of the nation鈥檚 largest not-for-profit health systems were well above $1 billion and in some cases approached $2 billion. These losses were driven by multiple factors, including ongoing operational disruptions related to the COVID-19 pandemic, staffing shortages that limited the ability to run operations at full capacity, rapidly escalating costs for supplies and鈥攅specially鈥攍abor (including the heightened use of expensive contract labor to help ease staffing shortages), and investment losses.</p> <hr> <h3 id="figure1">Figure 1: Kaufman Hall Operating Margin Index (Year-to-Date by Month), February 2022 鈥揓anuary 2023</h3> <p><img alt="Figure 1: Kaufman Hall Operating Margin Index (Year-to-Date by Month), February 2022 鈥揓anuary 2023. February 2022: -3.6%. March 2022: -2.4%. April 2022: -2.8%. May 2022: -2.1%. June 2022: -1.0%. July 2022: -1.3%. August 2022: -0.8%. September 2022: -0.8%. October 2022: -0.7%. November 2022: -1.0%. December 2022: -0.7%. January 2023: -1.0%." data-entity-type="file" data-entity-uuid="ad9fccc5-1bab-4aec-a848-d3a9c352cb2e" src="/sites/default/files/inline-images/Figure-1-Kaufman-Hall-Operating-Margin-Index-February-2022-January-2023.png" width="830" height="310"></p> <p><small>Source: Kaufman Hall, <em>National Hospital Flash Report,</em> February 2023</small></p> <hr> <p>With no immediate end in sight to the operational and financial pressures hospitals and health systems are facing, organizations will have to rely on their financial reserves to carry them through until conditions improve, or until organizations can adapt to a potential new reality of decreased revenue and increased expenses.</p> <blockquote> <h4>Not-for-profit hospitals and health systems have an obligation to their mission and the communities they serve, and strong financial reserves help ensure that they can meet this obligation even in times of operational disruption and financial distress.</h4> </blockquote> <p>This report looks, first, at the primary functions within the financial structure of not-for-profit hospitals and health systems and the role these functions play in generating financial reserves. It then looks at the significance of financial reserves in credit management efforts and in serving as a buffer in times of operational disruption or financial distress.</p> <div class="panel module-typeC"> <div class="panel-heading"> <h3 class="panel-title">Key Findings from the Report</h3> </div> <div class="panel-body"> <ul> <li>With limited sources of funding, not-for-profit hospitals and health systems rely on financial reserves to withstand periods of operational disruption or financial distress and continue to provide services to their communities.</li> <li>Most not-for-profit organizations maintain financial reserves to make needed investments and pursue their mission in difficult times. In the closely related not-for-profit sector of higher education, for example, financial reserves often surpass those that are held by hospitals and health systems.</li> <li>Strong financial reserves help improve a hospital or health system鈥檚 credit rating, which assists with borrowing money for needed facility and technology investments at more affordable interest rates.</li> <li>Strong financial reserves can also increase the amount of money a hospital or health system can borrow, an important safety valve if the organization needs additional funds to buffer the impact of poor financial performance from disrupted operations or an economic downturn affecting returns on investments.</li> <li>When all else fails, not-for-profit hospitals and health systems can draw upon their financial reserves to cover their operating expenses until they are able to stabilize their operations, or until their reserves are depleted.</li> <li>The ultimate purpose of financial reserves is to ensure that resources are available when hospitals and health systems鈥攁nd the communities they serve鈥攏eed them the most.</li> </ul> </div> </div> <p><strong><em><a href="/system/files/media/file/2023/04/Essential-Role-of-Financial-Reserves-in-Not-for-Profit-Healthcare.pdf" target="_blank" title="Click here to download The Essential Role of Financial Reserves in Not-for-Profit Healthcare PDF."><span>Download the full report.</span></a></em></strong></p> <hr> <ol> <li id="fn1">A very small percentage of not-for-profit hospitals and health systems can also generate meaningful funds through philanthropy, but most organizations do not have the capabilities for significant fundraising efforts.</li> </ol> </div> <div class="col-md-4"> <div class="panel module-typeC"> <div class="panel-heading"> <h3 class="panel-title">Media Coverage</h3> </div> <div class="panel-body"> <p><a href="https://www.fiercehealthcare.com/providers/industry-voices-financial-reserves-are-critical-fulfill-not-profit-hospitals-missions" target="_blank" title="Fierce Healthcare: Industry Voices鈥擣inancial reserves are critical to fulfill not-for-profit hospitals' missions of caring for all in their communities"><strong>Fierce Healthcare:</strong> Industry Voices鈥擣inancial reserves are critical to fulfill not-for-profit hospitals' missions of caring for all in their communities</a></p> </div> </div> <p><a href="/system/files/media/file/2023/04/Essential-Role-of-Financial-Reserves-in-Not-for-Profit-Healthcare.pdf" target="_blank" title="Click here to download The Essential Role of Financial Reserves in Not-for-Profit Healthcare PDF."><img alt="The Essential Role of Financial Reserves in Not-for-Profit Healthcare page 1. April 2023. A Kaufman Hall report prepared at the request of the 黑料正能量 Association. Kaufman Hall." data-entity-type="file" data-entity-uuid="3f08f5d1-d41a-465f-8819-9ee57e9b0815" src="/sites/default/files/inline-images/Page-1-The-Essential-Role-of-Financial-Reserves-in-Not-for-Profit-Healthcare.png" width="695" height="900"></a></p> </div> </div> </div> Wed, 19 Apr 2023 06:00:00 -0500 Not-for-profit /guidesreports/2022-06-03-estimates-federal-revenue-forgone-due-tax-exemption-non-profit-hospitals <div class="container"> <div class="row"> <div class="col-md-8"> <p>EY was commissioned by the 黑料正能量 Association to analyze the federal revenue forgone due to the tax-exemption of non-profit hospitals as well as the community benefits they provide.<sup><a href="#fn1">1</a></sup> This study presents estimates for 2019, the most recent year for which community benefit information is available for non-profit hospitals based on Medicare hospital cost reports for approximately 2,500 non-profit general hospitals. The analysis does not account for other non-profit specialty hospitals, such as psychiatric or long-term acute care.<sup><a href="#fn1">2</a></sup></p> <p>In 2019, the estimated tax revenue forgone due to the tax-exempt status of non-profit hospitals is $12.4 billion. In comparison, the benefit tax-exempt hospitals provided to their communities, as reported on the Form 990 Schedule H, is estimated to be $110.9 billion, almost 9 times greater than the value of tax revenue forgone.</p> <h2>Federal Revenue Forgone from Tax-Exempt Non-profit Hospitals in 2019</h2> <p>Three tax provisions that provide a federal exemption for non-profit hospitals are analyzed here:</p> <ol> <li>Federal corporate income tax-exemption;</li> <li>Tax-exempt bond financing; and</li> <li>Federal unemployment tax-exemption.</li> </ol> <p>Based on the data and methodology described below for non-profit general hospitals, <strong>the value of the federal revenue forgone due to these three tax-exemptions in 2019 is estimated to be $12.4 billion.</strong> This estimate reflects the upper bound of the potential value of the federal tax-exemption for two reasons:</p> <ol> <li>Some hospitals may be exempt due to their educational or religious nature, rather than their charitable nature. In the absence of a tax-exemption for charitable hospitals, certain institutions could continue to be exempted for other reasons.</li> <li>Certain features of the federal tax code are not reflected in this analysis due to a lack of necessary information, such as potential tax credits and accelerated depreciation. Additionally, potential taxpayer behavioral changes may occur if hospitals were subject to tax. These effects would likely reduce taxable income but have not been reflected in this analysis.</li> </ol> <h2>Total Community Benefit Provided by Tax-Exempt Non-profit Hospitals in 2019</h2> <p>Four items are included in tax-exempt hospitals鈥� total benefit to communities reported on Form 990 Schedule H:</p> <ol> <li>Financial assistance and means tested government programs and other benefits (Part I, line 7k of the Form 990 Schedule H);</li> <li>Community building activities (Part II of the Form 990 Schedule H);</li> <li>Medicare shortfall (Part III, line 7 of the Form 990 Schedule H); and</li> <li>Bad debt attributable to charity care (Part III, line 3 of the Form 990 Schedule H).</li> </ol> <p><strong>The total community benefit provided by tax-exempt hospitals is estimated to be $110.9 billion in 2019.</strong></p> <p><a href="/system/files/media/file/2022/06/E%26Y-Benefit-of-of-Tax-Exemption-Report-FY2019-FINAL-with-links.pdf"><em><strong>Read the full report.</strong></em></a></p> <hr /> <ol> <li id="fn1">The methodology used in this report is consistent with Ernst & Young studies previously completed on behalf of the 黑料正能量 Association (released February 2013, October 2017, and May 2019).</li> <li id="fn2">AHA鈥檚 2019 Annual Hospital Statistics Survey indicates there are 6,154 registered hospitals in the US. This includes community, federal government, psychiatric, long term care, and other hospitals. There are 5,194 community hospitals, which include non-governmental non-profit (2,966 hospitals), investor-owned for-profit (1,258 hospitals), and state and local government (970 hospitals). The remaining 960 hospitals are made up of the federal government, psychiatric, long-term care, and other hospitals (e.g., prison hospitals).</li> </ol> </div> <div class="col-md-4"> <p><a href="/system/files/media/file/2022/06/E%26Y-Benefit-of-of-Tax-Exemption-Report-FY2019-FINAL-with-links.pdf" target="_blank" title="Click here to download the EY estimates of federal revenue forgone tax exemption 2019 PDF."><img alt="report image" src="/sites/default/files/2022-06/EY-Estimates-of-the-federal-revenue-forgone-tax-exemption-2019-first-page.png" /></a></p> </div> </div> </div> Sun, 05 Jun 2022 15:08:55 -0500 Not-for-profit /node/681453 <p>This pamphlet is an example of an active DEI initiative at a health organization. They clearly define diversity and inclusion, why it's important, outlining their mission and explaining what they do, and identifying their leaders and members. Most importantly, they indicate how they should be percieved in the community and in the hospital so they may be held accountable.</p> Thu, 06 Jan 2022 15:02:13 -0600 Not-for-profit /financing-community-health-unlocking-investments-address-sdoh <p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span>In this webinar, the Center for Community Investment will share the basics about capital investment and how hospitals and health systems can leverage their existing resources for greater impact on health in their communities. It highlights CCI鈥檚 current initiative鈥擜ccelerating Investments for Healthy Communities鈥攖hat is designed to help participating hospitals and health systems deepen their community investment strategy through affordable housing, and advance policies and practices that foster equitable housing solutions.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Presenters:</strong></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <ul> <li>Robin Hacke, Executive Director, Center for Community Investment</li> <li><span>John Vu, Vice President, Strategy, Community Benefit, Research and Health Policy 鈥� Kaiser Permanente</span></li> </ul> <p> Your browser does not support the video tag. </p> Tue, 15 Oct 2019 10:17:45 -0500 Not-for-profit /news/headline/2018-03-01-study-340b-tax-exempt-hospitals-provide-517-billion-community-benefits <p>Tax-exempt hospitals in the 340B drug savings program provided $51.7 billion in total benefits to their communities in 2015, the most recent year for which data is available, according to an <a href="/system/files/2018-03/340b-community-benefit-analysis.pdf">analysis</a> released today by the AHA. 鈥淪avings from the 340B drug savings program allow eligible hospitals to provide a multitude of benefits to communities with a significant number of vulnerable patients,鈥� <a href="/press-releases/2018-03-01-new-analysis-shows-340b-tax-exempt-hospitals-provided-more-50-billion">said AHA President and CEO Rick Pollack</a>. 鈥淭hese benefits go well beyond financial assistance for needy patients and include care and services such as wellness clinics, nutritional services and mental health clinics, the addition of nurses, social workers and transportation services to serve vulnerable patients and many other vital services that would otherwise be unavailable.鈥� Funded by drug company discounts, not federal dollars, the 340B program was created by Congress more than 25 years ago 鈥渢o stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.鈥�</p> Thu, 01 Mar 2018 15:14:16 -0600 Not-for-profit /guidesreports/2018-03-01-340b-hospital-community-benefit-analysis <p>Improving the health of their communities is at the heart of every hospital鈥檚 mission.</p> <p>For example, every year, taxexempt hospitals demonstrate accountability to the communities they serve by filing a report on the benefits they provide to their community using the IRS Form 990 Schedule H and making it publicly available. In 2016, tax-exempt hospitals participating in the 340B drug savings program provided <strong>$56.1B in total benefits to their communities.</strong></p> <p><em>June 2019 update</em></p> Thu, 01 Mar 2018 12:11:53 -0600 Not-for-profit /news/headline/2017-12-06-aha-others-urge-congress-protect-tax-exempt-private-activity-bonds <p>A coalition of 35 national organizations, including the AHA, today urged House and Senate leaders to 鈥減rotect in full鈥� the current federal income tax treatment of private activity bonds, as envisioned by the Senate version of the Tax Cuts and Jobs Act. 鈥淥ur support of all tax-exempt bonds is grounded in the harsh reality that a loss or restriction of the tax-exemption of interest on these bonds would immediately increase costs to state and local governments and nonprofit organizations (such as nonprofit hospitals, universities and schools), in financing needed public services and the vital infrastructure that supports the economy,鈥� the organizations <a href="/system/files/advocacy-issues/letter/2017/171206-letter-groups-pabs.pdf" target="_blank">wrote</a>. 鈥淭his increase in cost will ultimately be borne by taxpayers, homeowners, renters, students, health care patients, commuters, air travelers, businesses relying on seaports, and other constituents.鈥� The group also expressed concern with a provision in both the House and Senate versions of the bill that would eliminate tax exemption for advance refunding bonds, and asked congressional leaders to delay the effective date to Dec. 31, 2018 or limit the provision to advance refunding of bonds issued after Dec. 31, 2017. <a href="https://www.speaker.gov/press-release/speaker-ryan-names-lawmakers-tax-reform-bill-negotiations" target="_blank">House Speaker Paul Ryan</a> (R-WI) and <a href="https://www.democraticleader.gov/newsroom/12417-8/" target="_blank">Democratic Leader Nancy Pelosi</a> (D-CA) this week named members to the conference committee that will reconcile differences between the House and Senate bills. Senate leaders are expected to name conferees later today.</p> Wed, 06 Dec 2017 10:07:00 -0600 Not-for-profit /letter/2017-12-06-groups-urge-legislators-protect-access-tax-exempt-bond-financing Wed, 06 Dec 2017 00:00:00 -0600 Not-for-profit /news/headline/2017-12-04-senate-passes-tax-bill <p>The Senate voted 51-49 early Saturday to approve <a href="https://www.congress.gov/bill/115th-congress/house-bill/1/text" target="_blank">tax reform legislation</a>, which includes provisions that would repeal enforcement of the Affordable Care Act mandate that most individuals have health insurance, eliminate hospitals鈥� ability to access low-cost capital financing through advance refunding bonds, and impose a 20% excise tax on pay for certain nonprofit hospital employees. The legislation now must be reconciled with the <a href="http://news.aha.org/article/171116-house-approves-tax-bill" target="_blank">House-passed bill</a>, which would not repeal the individual mandate but would eliminate tax-exemption for private-activity bonds, as well as advance refunding bonds, and the medical expense deduction for people with high medical costs. House and Senate leaders are expected to name conferees tonight. 鈥淲e are pleased that the Senate bill did not eliminate the tax-exemption for private-activity bonds for not-for-profit hospitals, protecting hospitals鈥� and health systems鈥� access to this vital source of low-cost capital,鈥� AHA President and CEO Rick Pollack <a href="/presscenter/pressrel/2017/120217-pr-taxbill.shtml" target="_blank">said</a> Saturday. 鈥溾�n addition, we are glad that the bill did not eliminate medical expense deductions for people with high medical costs and instead lowers the threshold for medical expense deductions from 10% to 7.5% for two years. We are also disappointed that the tax legislation passed with a provision that would [effectively] eliminate the individual mandate, which would result in the loss of health insurance coverage for millions of Americans.鈥�</p> Mon, 04 Dec 2017 09:54:00 -0600 Not-for-profit