Non Profit Tax Exempt Form The Worst Advices We’ve Heard For Non Profit Tax Exempt Form

August 17, 2017; Becker’s Hospital Review



The Internal Revenue Service (IRS) issued a letter in February of this year, afresh released, which appear the abolishment of a nonprofit hospital’s federal tax absolution for declining to accede with the Affordable Care Act, accurately the claim to conduct a “community bloom needs assessment” (CHNA), advance an activity plan based on the CHNA, and to “widely disseminate” the plan already it’s developed and accustomed by the hospital’s board.

A abstruse assay by WithumSmith Brown, PC discusses the requirements of the Internal Revenue Cipher (IRC) area 501(r), added to the tax cipher as allotment of the Affordable Care Act.



The name of the hospital has not been appear by the IRS, but it is a “dual status” hospital, operating with both accommodating tax-exempt cachet and authoritative status. According to WithumSmith, the hospital is additionally a federally appointed “disproportionate allotment hospital” (DSH), acceptation that a cogent allotment of the hospital’s revenues appear from patients covered by Medicare or paid for by accompaniment and bounded government application non-Medicaid and non-Medicare funds.

The bearding hospital’s bifold cachet may be the key to why its tax absolution was revoked. Beneath the ACA, the amends for a nonprofit hospital declining to accomplish a CHNA is a $50,000 customs tax, not abolishment of exemption. However, as WithumSmith notes,



[S]ince the administrators of the Hospital adumbrated that the Hospital did not charge to be tax-exempt and that it did not accept the banking adequacy or the agents to accede with IRC §501(r)(3), the IRS, in authoritative its adverse determination, declared that “Consequently, (Hospital’s) abortion to accommodated the requirements of §1.501(r)-3 is advised willful. Especially in ablaze of the actuality that the alignment bidding on several occasions that they did not charge to be absolved beneath IRC §501(c)(3) and that this cachet at times absolutely got in the way of their adeptness to be complex in assorted Medicare agreement programs.”

CHNAs are a well-intended claim because they animate nonprofit hospitals to do two things: 1) actualize their actuality as accommodating institutions rather than as medical organizations; and 2) appraise the healthcare-related needs of their communities after attention to the casework they currently accommodate or are planning to provide. Done correctly, CHNAs are not cheap. Initial amount estimates ambit from $60,000 to $150,000  depending on a nonprofit hospital’s admeasurement and the complication of the communities it serves. Small nonprofit hospitals operating on abbreviate margins and nonprofit hospitals already accident money see CHNA acquiescence as a above hurdle and attending for alternatives. NPQ has appear on examples of nonprofit hospitals voluntarily giving up their IRS tax absolved acceptance due in ample allotment to what they see as the burdens of nonprofit authoritative compliance.

The IRS’s activity is a cautionary account for all nonprofit hospitals, behindhand of abeyant bifold cachet as authoritative entities. As the law close Baird Holm addendum in a June 2017 blog post, the IRS is actively auditing nonprofit hospitals for acquiescence with Area 501(r), including its claim to accomplish a CHNA. NPQ has appear on the IRS’s contempo abstruse advances in cyberbanking assay of Form 990 returns, authoritative it far easier to analyze which hospitals address contravention on their Agenda H, the agenda accurately appropriate for nonprofit hospitals. Will added nonprofit hospitals be fined or accept their tax absolution placed at risk, and will added nonprofit hospitals adverse IRS administration activity adjudge to accord up tax absolution and about-face to for-profit or authoritative status?—Michael Wyland

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