ESSENTIALITY: Hospital Credit Analysis

By Dr. David Edward Marcinko MBA MEd

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SPONSOR: http://www.MarcinkoAssociates.com

Why Hospital Essentiality?

An important component of hospital credit analysis is essentiality. Hospitals are unusual businesses that many times possess some form of essentiality to their communities. Health care is important to the economic vitality of every community. Many hospitals have served their communities for many years; it is not uncommon to find hospitals that have been continuously operating for more than 100 years in the same community.

Most hospitals are not-for-profit. In not-for-profit hospitals, no private party actually “owns” the hospital; control is vested in various boards, but no one explicitly owns a not-for-profit hospital. In a broad sense, communities own not-for-profit hospitals. They are considered “charities” with a “charitable purpose.” Though a not-for-profit hospital may not have owners, it has many “stakehold-ers,” parties that have vested interests in the continuing success of the hospital.

HOSPITAL TYPES: https://medicalexecutivepost.com/2025/08/06/hospitals-understanding-different-types/

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Many hospitals have broad and vast webs of stakeholders. Stakeholders are why hospitals rarely close or are shut down. Too many stakeholders have interests in the continuing successful operation of hospitals.

Another dimension of the essentiality analysis is service analysis. How significant are the hospital’s services? If the hospital shuts down, what population segments would suffer? How significant is the population that would suffer? How much would they suffer?

HOSPITAL ROI: https://medicalexecutivepost.com/2024/10/09/the-dupont-decomposition-equation-for-roi/

Assessment

And so, hospital stakeholder relationships need to be considered in the analysis of essentiality. How strong are these relations? How many are there? How important is the continuing success of this hospital to these stakeholders?

Analysis of hospital’s stakeholders and services should provide a credible view of the degree of essentiality associated with a hospital. Higher degrees of essentiality suggest higher likelihoods that hospitals, one way or another, will meet their commitments, particularly their payment
commitments.

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CHARITY LURE: Identifiable Victim Effect

IDENTIFIABLE PERPETRATOR EFFECT

By Staff Reporters

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According to colleague Dan Ariely PhD, the The Identifiable Victim Effect [IVE] is why we’re more moved by one person’s story than by statistics. It’s easier to empathize with a single, identifiable victim than with a faceless group. Charities know this and often highlight individual stories to tug at our heartstrings. It’s a powerful reminder that our compassion is wired for personal connections.

The identifiable victim effect has two components. People are more inclined to help an identified victim than an unidentified one, and people are more inclined to help a single identified victim than a group of identified victims. Although helping an identified victim may be commendable, the identifiable victim effect is considered a cognitive bias. From a consequential point of view, the cognitive error is the failure to offer N times as much help to N unidentified victims.

The identifiable victim effect has a mirror image that is sometimes called the identifiable perpetrator effect. Research has shown that individuals are more inclined to mete out punishment, even at their own expense, when they are punishing a specific, identified perpetrator.

So, when you hear a touching story that makes you want to help, remember: it’s your brain responding to the power of a single, human face.

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IRS Announces Online “EO” Search Tool

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About “Exempt Organizations Select Check”

By Children’s Home Society of Florida

The IRS announced last week that it has created an online search tool called Exempt Organizations Select Check. The new search tool is very useful in understanding whether a charitable organization currently qualifies for deductible gifts.

Internal Revenue Service Website

On www.IRS.gov, select Charities and Nonprofits – More Topics. On the right side of the screen, select Search for Charities and load the Exempt Organizations Select Check page.

The new page allows three types of searches.

1. Exempt Organization Publication 78 Organizations qualified to receive deductible contributions.

2. Non-exempt Organizations – Because many smaller organizations did not file Form 990-N (ePostcard), their exemptions were automatically revoked.

3. Qualifying Form 990-N Organizations Those organizations that did comply with the ePostcard notice are listed.

Editor’s Note: Advisors or board members of charities may find the new EO Select Check useful in determining whether a charity has complied with the requirements to file IRS Form 990, Form 990-EZ or IRS Form 990-N. If an organization is no longer exempt it may be appropriate to file a new IRS Form 1023 and apply for exempt status.

Conclusion

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