Richard L. Clarke, DHA, FHFMA

"I wish Senator Grassley was sitting here with us for that last discussion."

I spoke these words during the January meeting of the Board of CHRISTUS Health, headquartered in Dallas. The board had been discussing the organization's mission, values, and community service. The discussion was wide ranging, but every word spoken had a sharp focus: to make a difference in the lives of those served by this large health system. This discussion moved me more than any written description or valuation of community benefit ever could because it showed so clearly that the desire to help people is a fundamental operating tenet of the organization.

I usually don't quote myself, but I believe my comment about Grassley is worth capturing. If only hospitals could communicate this depth of community service to those who scrutinize their tax-exempt status.

For tax-exempt organizations, benefiting the community is the reason for existence. Without it, these organizations may as well be taxable entities. The social cost of tax exemption is earned through broad-based community benefit. So while the reporting burdens created by the new Form 990 and accompanying schedules are daunting, it is critical that the words and numbers reported reflect the essence of what the organization is trying to accomplish.

In this issue of hfm, Jeni Williams discusses an approach to completing the new Form 990. The experts consulted for the article encourage developing a multidisciplinary group to address how to meet the reporting demands, reviewing programs currently counted as community benefit to ensure they meet IRS standards, collecting community benefit data in "real time," and using 2008 as a dry run. Very helpful suggestions.

And HFMA has been in the forefront of helping members with the identification, valuation, and financial reporting of community benefits, charity care, and bad debt. These efforts are aimed at ensuring the organization accounts properly for what is being done.

But the essence of community benefit reporting is that it reflects the sincere actions of the organizations. Healthcare leaders, including governance, must focus not on how to count and report what is being done, but rather on ensuring that what is being done really makes a difference. Think about your activities in a given week or month-the meetings attended, reports written, staff counseled, and vendors consulted. Think about your strategic and tactical concerns-expanding service volume, improving cash flow, controlling costs. Every one of those activities and concerns should embody a core goal: to continuously improve the community.

True community benefit reporting is about how the community benefits from our decisions.

Publication Date: Saturday, March 01, 2008

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