Date of Award
2026
Document Type
Capstone
Degree Name
Master of Nonprofit Studies
Abstract
Nonprofit hospitals play a unique role in the healthcare system: in exchange for tax- exempt status, they are expected to provide “community benefits,” such as charity care, health programs, and community investments. While this spending represents a major opportunity to improve population health and address disparities, stakeholders debate how expectations should be set, measured, and regulated to ensure mission adherence while maintaining nonprofit autonomy. This study explores how community benefit spending allocation is actually determined, leveraging interviews with decision-makers at large nonprofit hospital systems in Virginia. Findings consider the role of factors such as Community Health Needs Assessments and strategic priorities, reporting requirements, measurement challenges, financial sustainability, and further distinctions in shaping allocation choices. Clarifying these dynamics can help hospitals, policymakers, and health systems ensure that investments are used as effectively as possible, enhancing accountability and health outcomes in the Commonwealth.
Recommended Citation
Hinkle, Zelda, "Community Benefit Spending Decisions at Virginia’s Nonprofit Hospitals" (2026). School of Professional and Continuing Studies Nonprofit Studies Capstone Projects. 38.
https://scholarship.richmond.edu/spcs-nonprofitstudies-capstones/38