Cherry-picking patients: It might be business as usual for many hospitals.

Scrutiny of hospitals' business practices could up the ante in the debate over tax breaks given to not-for-profit organizations.

Hospital service offerings: does Catholic ownership matter?

Controlling for market and organizational characteristics, Catholic hospitals in 2001 offered more stigmatized and compassionate care services than investor-owned hospitals, and more stigmatized services than public hospitals. There were no differences between Catholic hospitals and other nonprofit hospitals, however, in the number of compassionate, stigmatized, and access services offered. This may reflect growing isomorphism in the nonprofit hospital sector.

Not-for-profit versus for-profit health care providers--Part II: Comparing and contrasting their records.

The debate over which health care providers are most capably meeting their responsibilities in serving the public's interest continues unabated, and the comparisons of not-for-profit (NFP) versus for-profit (FP) hospitals remain at the epicenter of the discussion. From the perspective of available factual information, which of the two sides to this debate is correct? This article is part II of a 2-part series on comparing and contrasting the performance records of NFP health care providers with their FP counterparts. Although it is demonstrated that both NFP and FP providers perform virtuous and selfless feats on behalf of America's public, it is also shown that both camps have been accused of being involved in potentially willful clinical and administrative missteps. Part I provided the background information (eg, legal differences, perspectives on social responsibility, and types of questionable and fraudulent behavior) required to adequately understand the scope of the comparison issue. Part II offers actual comparisons of the 2 organizational structures using several disparate factors such as specific organizational behaviors, approach to the health care priorities of cost and quality, and business-focused goals of profits, efficiency, and community benefit.

States turn up the heat. As self-regulation sputters, state legislatures are leading charge for more accountability in governance of not-for-profit hospitals.

Recent scandals have pushed some states to tackle transparency and governance issues at healthcare not-for-profits, which the federal government has been reluctant to touch. Rhode Island Lt. Gov. Charles Fogarty, left, supports a bill in his state that would establish a code of ethics for hospital boards. Fogarty sees leaders as getting too comfortable in their jobs and working without accountability.

Keeping the contract: an interview with the new AHA chair-elect. Interview by Mary Grayson.

Kevin Lofton, CEO of Catholic Health Initiatives in Denver and chair-elect of the AHA, remains passionate about health care. In this first-person interview, he describes the need for hospitals to live up to their community contracts by building bridges with others, striving for transparency in safety and quality, and nurturing diversity on their executive teams.

Catholic health care's community-benefit role.

"While contemporary Catholic health care and other not-for-profit health care institutions excel in quality, innovation and technology, they remain community-benefit organizations, founded and sustained because of community need," Sister Carol Keehan, a Daughter of Charity who chairs the board of trustees of the Catholic Health Association of the United States, said in May 26 testimony in Washington before the House Ways and Means Committee, which conducted a hearing on the tax-exempt hospital sector. Keehan chairs the board of Sacred Heart Health System in Pensacola, Fla. She spoke the day after Sen. Chuck Grassley, R-Iowa, announced that the Senate Finance Committee, which he chairs, had asked 10 nonprofit hospitals or health systems to account for their charitable activities in light of their tax-exempt status. Rep. Bill Thomas, R-Calif., chairman of the Ways and Means Committee, said at the House hearing that "the standards for tax exemption are not just an academic debate." In reviewing the broad ways Catholic hospitals benefit local communities, Keehan stressed that the services of Catholic hospitals are not provided "to justify continued tax exemption" but because serving communities in this way is integral to their identity and mission. Keehan's text follows.

Community benefit: what it is and isn't.

"Community benefit" is the measurable contribtution made by Catholic and other tax-exempt organizations to support the health needs of disadvantaged persons and to improve the overall health and well-being of local communities. Community benefit activities include outreach to low-income and other vulnerable persons; charity care for people unable to afford services; health education and illness prevention; special health care initiatives for at-risk school children; free or low-cost clinics; and efforts to improve and revitalize communities. These activities are often provided in collaboration with community members and other community organizations to improve local health and quality of life for everyone. Since 1989, the Catholic health ministry has utilized a systematic approach to plan, monitor, report, and evaluate the community benefit activities and services it provides to its communities. This approach, first described in CHA's Social Accountability Budget, was updated in the recent Community Benefit Reporting: Guidelines and Standard Definitions for the Community Benefit Inventory for Social Accountability. By using credible and consistent information, health care organizations can improve their strategic response to demands for information that demonstrates their worth.

Taking the high road.

Somehow, over time, ethics has been neglected at conferences and even in articles in many association publications. Thinking about how many times we open the newspaper to read about corporate scandals, why shouldn't we be just as concerned about the "ethics" of how we go about our business of fundraising?