Provena Covenant Medical Center, a non-profit hospital in Champaign, IL, lost its tax-exempt status five years ago when local officials determined it was not providing enough charity care for needy patients. In 2008, the state Supreme Court agreed to review an August state Appellate Court ruling that dealt a huge setback to non-profit hospitals. Provena's attorneys argued that free care should not be the sole criteria when deciding whether a hospital is a charitable institution, but the appeals court rejected that position. The decision sent shock waves through Illinois non-profit hospitals, which account for roughly three out of every four hospitals in the state and more than half of all hospitals in the country.