Changes in service availability in california hospitals, 1995 to 2002.

Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied.

Endangered species? Not-for-profit hospitals face tax-exemption challenge.

The recent decision by the Illinois Department of Revenue to revoke the tax-exempt status of Provena Covenant Medical Center is just one indication of a larger trend in which states are increasingly questioning the exchange of social contributions by not-for-profit hospitals for favorable tax treatment. As yet, there is no consensus on how charity care or community benefits should be measured. Results of a study examining different states' specifications of charity care indicate that alternate definitions of charitable contributions have a material effect on the total dollars recognized as charitable contributions.