Charitable expectations of nonprofit hospitals: lessons from Maryland

Little is known about nonprofit hospitals' community benefit spending other than for charity care. Better accountability is desirable, but critics have focused too narrowly on charity care. Using data from reporting requirements in Maryland similar to federal rules that take effect in 2010, we describe the broad range of community benefit spending in nonprofit hospitals there, which amounted to 7.4 percent of expenses in 2007. Charity care for hospital services accounted for one-third of this amount (payments to physicians for charity patients are reported separately). Hospitals' community benefit spending varies with local needs, resources, and resource allocation decisions.