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1 – 10 of over 8000Catherine Plante and Linda Ragland
The purpose of this paper is to add to the stream of research examining the difference between the amount of taxes waived for nonprofit hospitals and the amount of charity care…
Abstract
Purpose
The purpose of this paper is to add to the stream of research examining the difference between the amount of taxes waived for nonprofit hospitals and the amount of charity care they provide.
Design/methodology/approach
The study is an archival study.
Findings
Almost all nonprofit hospitals in the sample provide enough charity care to cover their waived taxes. Almost none provide enough charity care at the level that has been proposed to the federal government for hospitals to maintain their nonprofit status.
Research limitations/implications
As with most hospital research, a limitation is this study’s focus on a single state to control for regulatory differences among states.
Practical implications
The data on the new Form 990 allow better measurement and transparency regarding a nonprofit hospital’s charity care. For legislators, regulators, and taxpayers, the results from this study raise questions about: the large variations in the amount of charity care provided among nonprofit hospitals and whether enough is being done in terms of providing charity care.
Social implications
There is great variation among nonprofit hospitals as to the amount of charity care provided. Relying upon a nonprofit hospital’s altruistic nature may not be enough to ensure that they act in the best interest of society.
Originality/value
This study is unique because, for the first time, a true measure of taxes waived is used in the analysis. All previous research has had to proxy taxes.
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Rabih Zeidan and Saleha Khumawala
This study examines whether nonprofit hospitals (NPHs) use price increases to overstate reported charity care spending. Anecdotal evidence points to hospitals raising prices to…
Abstract
This study examines whether nonprofit hospitals (NPHs) use price increases to overstate reported charity care spending. Anecdotal evidence points to hospitals raising prices to maximize Medicare's supplemental reimbursement and to maximize collection from self-pay and uninsured patients. This study provides empirical evidence that NPHs raise prices in part to satisfy the state's charity care requirements and to substitute real care with price-valued charity care. The ratio of charges to costs (RCC), price standardized by cost - a measure for comparing revenues generated to estimate costs allocations, is used to test the association between price increases and charity care reporting by NPHs. We hypothesize and find evidence that NPHs facing financial and political pressures in addition to charity care regulations are more likely to report a higher value of charity care.
This paper aims to examine the puzzles of “ownership”, the legal and psychological commitment of directors, through the experience of the work of boards at non-profit…
Abstract
Purpose
This paper aims to examine the puzzles of “ownership”, the legal and psychological commitment of directors, through the experience of the work of boards at non-profit organisations.
Design/methodology/approach
An exploration of the literature on charity governance leads to a first-person reflection on the tensions in directing two common types of non-profit organisations.
Findings
In the UK as in other countries, charities are companies, bound by company law as well as regulatory constraints of the non-profit sector. This creates responsibilities of ownership without the material benefits. In contrast to corporate share ownership, a sense of psychological ownership may pre-date appointment as a director, facilitating stewardship behaviour, facilitating stewardship and accountability.
Research limitations/implications
This paper calls for expanded empirical work on boards of non-profit organisations, giving a focused agenda of aspects to highlight the differences between charities and the corporate sector.
Practical implications
The focus on psychological ownership can influence recruitment, induction and organisation of the work of charity boards, helping to ease resource deficits.
Social implications
With pressure mounting in deliver of public services, the charity sector needs to fill growing gaps in provision. The constitution of boards plays a valuable role.
Originality/value
By incorporating psychological ownership in a framework of accountability, this paper points towards both a research agenda and practical considerations for charity boards.
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Elizabeth Parsons and Adelina Broadbridge
The purpose of this paper is to explore how gender identity is played out in a particular type of work setting, that of charity retail, and to explore the impacts of increased…
Abstract
Purpose
The purpose of this paper is to explore how gender identity is played out in a particular type of work setting, that of charity retail, and to explore the impacts of increased managerialism on this process of identity construction.
Design/methodology/approach
The paper is informed by interviews with 22 charity shop managers from three UK cities. The narratives of three of these managers are chosen for more in‐depth analysis. The paper focuses primarily on understandings of identity as practised, exploring the enactment of a series of conflicting and overlapping “selves” in the workplace. The practices and discourses surrounding the retail (or businesslike) self, the charitable self and the caring self in particular are discussed.
Findings
It was found that the process of creeping managerialism in the sector both values and promotes the discourses of “retail” but marginalises those of “charity and of care”. This presents serious dilemmas of identity for charity shop managers and is a source of considerable stress for them. However, it was also found that managers were using the discourses of charity and of care to resist this managerial process. Attention was paid to the ways in which gendered identities are constrained and enabled by and through the discourses circulating in organisational life. Presents a series of observations concerning the future possibilities that retail work in particular might offer for identity construction.
Research limitations/implications
The analysis is based on a small sample of qualitative interviews, therefore the findings are not meant to be generalisable to the wider population. This “vignette” approach allows us to explore in some depth the relations between identity construction and organisational context.
Originality/value
Empirical paper using an alternative lens to analyse gender identity and the impacts of increasing managerialism on processes of identity construction. Highlights in particular the continual struggles over meaning within organisations.
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Lawton R. Burns, Rajiv J. Shah, Frank A. Sloan and Adam C. Powell
Change in ownership among U.S. community hospitals has been frequent and, not surprisingly, remains an important issue for both researchers and public policy makers. In the past…
Abstract
Change in ownership among U.S. community hospitals has been frequent and, not surprisingly, remains an important issue for both researchers and public policy makers. In the past, investor-owned hospitals were long suspected of pursuing financial over other goals, culminating in several reviews that found few differences between for-profit and nonprofit forms (Gray, 1986; Sloan, 2000; Sloan, Picone, Taylor, & Chou, 2001). Nevertheless, continuing to the present day, several states prohibit investor-ownership of community hospitals. Conversions to investor-ownership are only one of six types of ownership change, however, with relatively less attention paid to the other types (e.g., for-profit to nonprofit, public to nonprofit). This study has two parts. We first review the literature on the various types of ownership conversion among community hospitals. This review includes the rate at which conversions occur over time, the relative frequency in conversions between specific ownership categories and the observed effects of conversion on hospital operations (e.g., strategic direction and decision-making processes) and performance (e.g., access, quality, and cost). Overall, we find that the impact of ownership conversion on the different measures is mixed, with slightly greater evidence for positive effects on hospital efficiency. As one explanation for these findings, we suggest that the impact of ownership conversion on hospital performance may be mediated by changes in the hospital's strategic content and process. Such a hypothesis has not been proposed or examined in the literature. To address this gap, we next study the role of strategic reorientation following hospital conversion in a field study. We conceptualize ownership conversion within a strategic adaptation framework, and then analyze the changes in strategy content and process across sixteen hospitals that have undergone ownership conversions from nonprofit to for-profit, public to for-profit, public to nonprofit, and for-profit to nonprofit. The field study findings delineate the strategic paths and processes implemented by new owners post-conversion. We find remarkable similarity in the content of strategies undertaken but differences in the process of strategic decision making associated with different types of ownership changes. We also find three main performance effects: hospitals change ownership for financial reasons, experience increases in revenues and capital investment post-conversion, and pursue labor force reductions post-conversion. Membership in a multi-hospital system, however, may be a major determinant of both strategy content and decision-making process that is confounded with ownership change. That is, ownership conversion may mask the impact of system membership on a hospital's strategic actions. These findings may explain the pattern of performance effects observed in the literature on ownership conversions.
This study aims to examine the role of devices in assessing the social impact of an organization. The study examines the effects of device and analyst expertise on the contents…
Abstract
Purpose
This study aims to examine the role of devices in assessing the social impact of an organization. The study examines the effects of device and analyst expertise on the contents and conclusions of the report.
Design/methodology/approach
Six impact reports based on the same data from the same organization were compared to each other, to the charity data and to the devices used. Specific attention is paid to the role of the device’s sociomaterial form and discursive entanglements.
Findings
The six reports assessed the impact differently from each other and in ways that were consistent with the devices used. The devices performatively reconfigured the charity in impact reports through a series of omissions and misrepresentations which could be traced to the discourses hardwired into the devices themselves. The devices did not simply present the same impact assessment to different audiences or for different purposes, but (mis)represented the charity in specific ways aligned with the discursive entanglements.
Research limitations/implications
The performativity of sociomaterial impact devices has implications for how researchers approach the study of impact measurement.
Practical implications
In this study, faithful adherence to an impact device led to greater omissions and misrepresentations than less expert impact assessments. Analysts should be supported to identify biases in their devices and be aware of sorts of omissions and misrepresentations that may result. Faithful adherence may not be the mark of rigorous analysis.
Originality/value
Performativity of impact measurement devices is explored with a unique data set.
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The conventional wisdom in economics is that resources are limited,wants are unlimited, and the business of the economist is to understandhow limited resources are allocated to…
Abstract
The conventional wisdom in economics is that resources are limited, wants are unlimited, and the business of the economist is to understand how limited resources are allocated to satisfy unlimited wants. Typically, poverty or unmet physical need is addressed apart from consumer behaviour. It was not always so. Adam Smith, Alfred Marshall, and Paul Samuelson as recently as 35 years ago, for example, were explicit about the direct linkage between needs and wants. The changes that have taken place over the years are attributable to a shift away from an Aristotelian perspective on the nature of economic studies towards the Enlightenment view. Challenges the conventional wisdom that wants are virtually unlimited, resources are limited, and poverty is best addressed apart from wants. Presents need fulfilment alongside want satisfaction in the context of the principle of subsidiarity which helps define the role of the state in provisioning unmet need.
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Saeedeh Fehresti, Amirhossein Takian, Ebrahim Jaafaripooyan, Mahboubeh Parsaeian and Habib Jalilian
This study aims to predict the behavior of donors to give to the health sector compared with other sectors in Shiraz city, South Iran, using the revised theory of planned behavior…
Abstract
Purpose
This study aims to predict the behavior of donors to give to the health sector compared with other sectors in Shiraz city, South Iran, using the revised theory of planned behavior (TPB).
Design/methodology/approach
This was a descriptive-analytic cross-sectional study. A standard questionnaire, which comprising 32 items, was used to survey 277 donors affiliated with various charitable associations in the city of Shiraz, South of Iran, in 2018. Participants were selected using stratified sampling and simple random sampling techniques. The authors used a revised TPB, a general model to predict and explain behavior across various types of behaviors and predict behavior based on an individual’s attitudes and beliefs. This model was used to examine the influence of eight social-psychological variables (attitude, perceived behavioral control [PBC], subjective norm, descriptive norm, moral norm, past behavior, intention behavior, self-reported) on an individual’s intention to donate to health sector charity. Data was analyzed using SPSS software version 22.0.
Findings
The score of all constructs of TPB in the health sector was significantly higher than in the non-health sector (P < 0.001), except for the PBC. This indicates that it does not influence the donors’ behavioral intention in selecting of charitable activity domains (e.g. health and non-health). The constructs of the moral norm, descriptive norm and past behavior in the health sector donors; and the constructs of attitude, moral norms and the variables of the annual income, and work experience in the non-health sector donors were identified as significant predictors of donors’ intention behavior. Moreover, attitude, moral norm, descriptive norm, past behavior, male gender and the annual income were the significant predictors of donors’ intention to give to health charity initiatives.
Originality/value
One of the most important mechanisms to compensate for the shortage of resources of the health system is the use of donors’ participation capacity. However, different donors act differently in selecting charitable activity domains, including the health sector and non-health sector (e.g. school-building donors’ association, house-building donors’ association, city-building donors’ association, library-building donors’ association, etc.). To attract donors’ participation in the health sector, some interventions to change the behavioral intention of donors towards the health sector through constructs of TPB should be taken.
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Bronwyn Howell and Carolyn Cordery
Policy reforms to primary health care delivery in New Zealand required government-funded firms overseeing care delivery to be constituted as nonprofit entities with governance…
Abstract
Policy reforms to primary health care delivery in New Zealand required government-funded firms overseeing care delivery to be constituted as nonprofit entities with governance shared between consumers and producers. This paper examines the consumer and producer interests in these firmsʼ allocation of ownership and control utilising theories of competition. Consistent with pre-reform patterns of ownership and control, provider interests appear to have exerted effective control over these entitiesʼ formation and governance in all but a few cases where community (consumer) control pre-existed. Their ability to do so is implied from the absence of a defined ownership stake and the changes to incentives facing the different stakeholding groups. It appears that the pre-existing patterns will prevail and further intervention will be required if policy-makers are to achieve their underlying aims.