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Healthcare, Property Tax Exemptions and Implications from Recent Court Cases
Unformatted Document Text:  9 the word to be used over time—the “popular and ordinary” meaning, as well as the common law meaning. 27 The popular and ordinary meaning of the term denotes assistance to the poor or destitute; the common law meaning which evolved from English common law concerning charitable trusts refers to promotion of the common good. 28 Until 1969 the Internal Revenue Service (IRS) used the popular and ordinary meaning of charitable to enforce exemption requirements. In 1969 having been persuaded by hospital associations, that Medicare and Medicaid had significantly reduced hospitals’ charity care burden, the IRS promulgated new rules that relieved nonprofit hospitals of the obligation to provide free care as a condition of its tax exempt status, and replaced it with a community benefit standard. 29 The common law meaning of promotion of the common good was now understood to include promotion of health to the community as a whole. Evolution of the Modern Healthcare Institution and Exemption Challenges During the fifty-year period from 1870 to 1920, hospitals shed their image as charitable, but undesirable refuges for the homeless and sick poor. Transforming themselves from social institutions to institutions of medical science and healing, they became in the words of Rosenberg, “an ever-more bureaucratic and market-oriented organism.” 30 This transformation accelerated during the next four decades, as financing for hospital care became more secure due to employer paid insurance as well as Medicare 27 Bruce R. Hopkins, The Law of Tax-Exempt Organizations, 8th ed. (Hoboken: John Wiley & Sons, 2003) 104. 28 Ibid. 29 Daniel M. Fox and Daniel C. Schaffer, "Tax Administration as Health Policy: Hospitals, the Internal Revenue Service, and the Courts," Journal of Health Politics, Policy and Law 16.2 (1991): 260. 30 Charles E. Rosenberg, The Care of Strangers (Baltimore: The Johns Hopkins University Press, 1987) 253.

Authors: Fanning, Mary.
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background image
9
the word to be used over time—the “popular and ordinary” meaning, as well as the
common law meaning.
The popular and ordinary meaning of the term denotes
assistance to the poor or destitute; the common law meaning which evolved from English
common law concerning charitable trusts refers to promotion of the common good.
Until 1969 the Internal Revenue Service (IRS) used the popular and ordinary meaning of
charitable to enforce exemption requirements. In 1969 having been persuaded by hospital
associations, that Medicare and Medicaid had significantly reduced hospitals’ charity
care burden, the IRS promulgated new rules that relieved nonprofit hospitals of the
obligation to provide free care as a condition of its tax exempt status, and replaced it with
The common law meaning of promotion of the common
good was now understood to include promotion of health to the community as a whole.
Evolution of the Modern Healthcare Institution and Exemption Challenges
During the fifty-year period from 1870 to 1920, hospitals shed their image as
charitable, but undesirable refuges for the homeless and sick poor. Transforming
themselves from social institutions to institutions of medical science and healing, they
became in the words of Rosenberg, “an ever-more bureaucratic and market-oriented
organism.”
This transformation accelerated during the next four decades, as financing
for hospital care became more secure due to employer paid insurance as well as Medicare
27
Bruce R. Hopkins, The Law of Tax-Exempt Organizations, 8th ed. (Hoboken: John Wiley &
Sons, 2003) 104.
28
Ibid.
29
Daniel M. Fox and Daniel C. Schaffer, "Tax Administration as Health Policy: Hospitals, the
Internal Revenue Service, and the Courts," Journal of Health Politics, Policy and Law 16.2 (1991): 260.
30
Charles E. Rosenberg, The Care of Strangers (Baltimore: The Johns Hopkins University Press,
1987) 253.


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