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Charity care alone should not be used to determine providers’ tax-exempt status, according to research findings published in the journal Health Affairs.

Using care for the indigent as the only criteria is a “misguided approach to improving community health,” wrote researchers, including Mark Schlesinger, a professor of health policy at Yale University. The Internal Revenue Service recently launched a wide-ranging investigation of non-profit hospitals to see if any are skirting tax-exempt status rules.

Researchers also found some differences between nonprofits and for-profits in areas such as cost and care delivery. In general, they found that nonprofits “appear more trustworthy in delivering services,” and are “less likely to make misleading claims, to have complaints lodged against them.” But researchers added that nonprofit nursing homes tend to be run less efficiently.