High court rejected the idea of defining charity by the numbers, so health care facilities are charities even when they provide very little charity care. What's important is access to all.
With all the news over the last year about hospital charity care (including this one from last June), it was a surprise to me to find a case from the Michigan Supreme Court that rejected the idea that medical facilities need to provide a certain amount of charity care to qualify for charity treatment under Michigan property tax laws (Wexford Medical Group v. City of Cadillac). The court reversed the state's Tax Tribunal, which denied a property tax exemption to a nonprofit medical center that spent less than 1% of its budget on charity care. Wexford Medical Group (EIN 38-3450619 Form 990) had almost $11 million in fee income in 2004 and no charitable contributions at all.
The opinion advances the view that there is no precedent for setting a monetary threshold of charity care. The court set out these characteristics what a charity insitution:
- A nonprofit corporation
- Organized chiefly, if not solely, for charity
- Serving any sort of person who needs the services being offered (non-discrimination)
- Charging no more than what is needed for successful maintenance
From an old Massachusetts case (Jackson v Phillips 1867) the court picks up the definition of charity as anything that:
- brings people's minds and hearts under the influence of education or religion;
- relieves people’s bodies from disease, suffering, or constraint;
- assists people to establish themselves for life;
- erects or maintains public buildings or works;
- or otherwise lessens the burdens of government.
Under this test, the intent is enough. Part of the reasoning seems to be that the courts wouldn't have a basis for setting an appropriate percentage of charity care, so in the absence of legislation they won't go down that road at all.
There is, of course, the tax officials have made a similar tax finding in Illinois against Provena Covenant Medical Center in Urbana, holding it responible for property tax due to a lack of charity care, but that is just at the beginning of the appeal process through the courts. (Group return for Provena Hospitals EIN 36-4195126 Form 990) This Michigan case likely foreshadows the outcome of that case.