Provide names of other journalists involved.
Joe Carlson
List date(s) this work was published or aired.
Dec. 19, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
For decades, the majority of U.S. hospitals have operated with generous tax breaks and almost no measure of how they earned them. Private not-for-profit hospitals, which receive property, sales and income tax breaks, account for 58% of U.S. community hospitals. The sector has operated without any national requirement that not-for-profit hospitals report–to the public or federal regulators–how they gave back to communities in exchange for tax exemptions granted to charities. That changed this year. Not-for-profit hospitals must now disclose charitable activities to the Internal Revenue Service and that disclosure is public record. Modern Healthcare reporters Joe Carlson and Melanie Evans, working with exclusive data provided by the charity watchdog GuideStar, analyzed roughly 1,800 not-for-profit hospital disclosures for what may be the first national snapshot of how much not-for-profit hospitals spend to benefit their communities. The analysis found the median nonprofit hospital spent 1.52% of total expenses on free and discounted medical care for low-income patients. The discovery of that previously unknown figure was one of the main drivers though years of inquiries and Congressional hearings on not-for-profit hospitals’ charitable spending. The story, published in December, followed up and expanded on reporting by Carlson and Evans in March, when they analyzed a smaller batch of disclosures with the first public reporting deadlines. Hospitals’ reporting deadlines are staggered throughout the year. The March story found hospital profits did not guarantee of high levels of free or discounted care for low-income patients.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Carlson and Evans analyzed 28 fields of data for roughly 1,800 not-for-profit hospitals and systems that filed a Schedule H with the IRS in tax year 2009. The magazine requested GuideStar analyze its database of all IRS nonprofit tax filings, and create a data run of every hospital or system that filed a specific tax schedule only applicable to hospitals, called the Schedule H. The GuideStar file included 28 fields of data about each hospital system. Carlson and Evans then manually checked more than 100 of hospital tax forms that appeared to be outliers.
Explain types of human sources used.
The reporters interviewed or received comment from patient advocates, academics, a member of Congress and officials with hospitals, health systems and trade groups.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
Joe Carlson used Guidestar data to analyze hospitals’ profits or losses on Medicare patients, finding that about one-third of all hospitals earn profits on Medicare despite industry claims that reimbursement rates are too low. The magazine also recently received permission to create an online portal to allow the public to search for their local hospitals to see how they stack up against industry averages. Work on that project is ongoing as of January 2012.
Advice to other journalists planning a similar story or project.
Give yourself time to clean up the database and get comfortable with analyzing the numbers. We flagged outliers and followed up by double-checking original documents and with phone calls to check out potential errors.