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(Crain’s) — In a decision that could have national implications for non-profit
hospitals, an Illinois revenue official ruled Friday that the state was right to
deny an Urbana hospital a property tax exemption. 
Brian Hamer, director of the Illinois Department of Revenue, ruled that Provena
Covenant Medical Center failed to prove that it provided enough free medical
care to the needy to qualify for a tax exemption from Champaign County.  The
hospital has paid nearly $5 million in property taxes to Champaign since county
officials stripped it of its tax-exempt status in early 2003. The state earlier
upheld that decision. 
“Given the very limited amount of charitable care offered, I cannot conclude
that Provena’s primary purpose is the provision of charity,” Mr. Hamer wrote in
a 35-page ruling posted on the department’s Web site Friday. 
Mr. Hamer’s decision went against a recommendation from an administrative law
judge.
William Foley, CEO of Mokena-based Provena Health, the six-hospital health
system that owns the medical center, vowed to appeal the ruling in circuit
court. 
“This goes against over 100 years of legal precedent supporting non-profit
hospitals as charitable institutions,” Mr. Foley said. 
The decision ratchets up what is already intense pressure on non-profit
hospitals, both in Illinois and nationally, to justify their tax-exempt status.
Experts have said the ruling could embolden other counties and municipalities to
revoke tax exemptions for non-profit hospitals or more closely scrutinize their
charitable offerings. 
“This is like raw meat for other counties,” said Gerald Griffith, a health care
lawyer in Chicago for law firm Jones Day. 
Illinois Attorney General Lisa Madigan is pressing non-profit hospitals to
provide more free medical services in exchange for the break they get on taxes.
U.S. Sen. Charles Grassley, R-Iowa, is pushing for tougher federal standards for
tax-exempt hospitals. 
The ruling is “an important victory for Illinois taxpayers,” Ms. Madigan said in
a statement. “Illinois hospitals receive huge tax breaks and in exchange have a
constitutional obligation to provide substantial charity care to the community.” 
 
Mr. Hamer found that Provena reported $831,724 in charitable activities on
revenue of $113 million in 2002, the year before it lost its tax exemption. It
requested a property tax exemption worth $1.1 million. 
Mr. Foley of Provena called the decision “politically motivated,” claiming it
was aimed at boosting Ms. Madigan’s efforts. She backed a bill earlier this year
that would have required hospitals to dole out more free care. It didn’t pass,
but she’s expected to put forth a similar measure next year. 
“If he had ruled in our favor, we think that might have negatively affected the
attorney general when she comes back with her bill next session,” Mr. Foley
said. 
A spokesman for Mr. Hamer declined to comment. 
The Illinois Hospital Assn. (IHA), which contributed $175,000 to Gov. Rod
Blagojevich’s campaign during the first half of this year, quickly denounced his
administration’s decision, calling it “disturbing and outrageous.” 
“If not overturned, this decision would call into question the tax-exempt status
of all charitable organizations in Illinois,” including museums and theaters,
IHA president Kenneth Robbins said in a statement.