All of the nation's nearly 3,000 nonprofit hospitals are increasingly being called upon to defend their tax-exempt status by demonstrating, in a quantifiable manner, the benefits they bring to their communities. This contribution, collectively called "community benefit," is comprised of three core categories: charity care; health research, education, and training; and benefits directed at vulnerable populations and the community-at-large.
Telling this story and comparing one hospital's performance to another is not as simple as it might appear because there does not presently exist any uniform reporting standard or a universal method for calculating economic value. Accordingly, a growing number of state auditors are finding inconsistent data and are suggesting that statewide tax boards more closely monitor the situation in order to better determine true economic value. To that add the fact that a number of media reports, from the Los Angeles Times in December 2007 to the Wall Street Journal in April 2008, are calling for heightened awareness of this issue. Some even are questioning the profits being made by tax-exempt hospitals, which are intended to exist for public good.
Make no mistake, this issue is now high on our government's radar and is not going away. As a result, the American Hospital Association has taken the position that "hospitals should voluntarily, publicly, and proactively report to their communities on the full value of benefits a hospital provides."
Huntington Hospital is a 600-plus-bed medical center in Pasadena, CA. Like many of our fellow nonprofits around the country, we are proud of the role we have played throughout our history (in our case, 115 years) as the community's central healthcare resource. Still, we also must candidly concede that our story as it concerns community benefit has not been told well enough, particularly at a time when all nonprofit hospitals need to be doubly prepared for public scrutiny. Recognizing this, last year we decided to embark on a multi-pronged communication program designed to reach all of our targeted audiences including the board, employees, medical staff, volunteers, donors, regulators, legislators, and the community-at-large. This communication program is aimed at educating all of these groups by clearly articulating Huntington's contribution in this area and reaffirming the value we serve as a nonprofit hospital existing for community good.
Our communication program is comprised of the following 10 ingredients:
1. As with all good public relations programs, we began by developing a set of key message points that tell our story in a compelling and understandable way. These points have become the backbone of our entire communication program and help ensure consistency of and focus on the message.
2. We know that a well-informed board can serve as ambassadors on our behalf. As a result, we spent time at a board meeting explaining what community benefit is all about, showing Huntington's contributions in this area and discussing how we track performance on an ongoing basis. Now, we intend to report back to the board throughout the year and be held accountable for how we are doing.
3. To instill both an understanding of and an appreciation for community benefit, we have made it an important component of our employee forums, we educate new employees about it in orientation, and we give an annual update on the topic at our annual state of the hospital address. Our goal is to make sure that every employee understands how community benefit is woven into the fabric of our institution and recognizes the role they are expected to play in embracing this mission.
4. We updated our fact sheet, "quick guide," and standard hospital boilerplate (part of all news releases) to include a reference to community benefit. Our addition reads: "Consistent with its nonprofit mission, last year Huntington Hospital provided approximately $44.7 million (or 11% of our revenue) in recognized community benefit through uncompensated care, medical education and the provision of much-needed services (including trauma care) not found anywhere else in the region."