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Why Nonprofits Must Prepare Now for Closer IRS Scrutiny

Philip Betbeze, for HealthLeaders Media, September 30, 2011

Regier predicts Congress will again have to weigh in as the process is tweaked, but with the idea that future standards will come from establishing the baseline, Regier says hospitals must do the difficult, almost fortune-telling work of determining where they might fall on the community benefit bell curve.

"In part that's because organizations have established patterns of community benefit work," Regier says. "Will that be seen as adequate? If not, will that put my tax status in jeopardy? Are there squandered investments here?" he asks rhetorically.

The answer is, no one really knows. But the work doesn't have to rely on predicting future standards, Regier adds. He says generally, hospitals and health systems should remember that IRS form 990, the annual information return, is a public relations document in addition to a regulatory compliance document. See if it passes the "smell test." 

"Make sure the story of your organization is told in a complete, authentic way and shows you in the best light that you can," he says. "Secondly, don't rely on your form 990 to tell your story to the community.

You have to get the word out, he says, with a public relations effort. After all, nobody will tell your story for you.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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1 comments on "Why Nonprofits Must Prepare Now for Closer IRS Scrutiny"


bob (9/30/2011 at 9:47 PM)
Regler does not seem to understand the essential difference between programs to improve population health and programs to improve community health. Both represent significant advances over the more traditional limited focus on patient care at most hospitals. Focusing on population health introduces methodologies reflecting the unique characteristics of various populations, especially those with comprehensive coverage and systematic management. Focusing on community health introduces even more exciting and quite different methodologies reflecting the power of community forces. Methodologies for improving population health do not necessarily focus on communities or take advantage of the power of effective community benefit projects and programs. Those professionals involved in community health improvement know that no two communities are alike and the leadership of each community is unique and most be actively involved in designing community benefit projects. I do not know of any existing health system with an active community benefit program in which the various initiatives are not designed and carried out at the local level. The affordable heath care act recognizes that reality, and should not be changed. Regler is well advised to support community benefit programs designed to improve community health rather than the health of particular enrolled or un-enrolled populations. I am sure he knows that a health system's service area does not meet anyone's definition of a community.