Mission, Margin, and Trust in the Nonprofit Health Care Enterprise

Authors

Thomas L. Greaney, Saint Louis University School of Law
Kathleen Boozang, Seton Hall School of Law; Seton Hall University - Center for Health & Pharmaceutical Law & Policy

Document Type

Article

Publication Date

2004

Keywords

antitrust, hospitals, hospital mergers, nonprofit organization, Clayton Act

Abstract

The law governing charitable corporations remains neglected and thoroughly muddled. Still unsettled are central issues regarding the accountability of directors and management, legal standards governing organic changes by nonprofit institutions, and mechanisms to ensure fidelity to the organization's charitable mission. For nonprofit corporations in the health care sector, which represent a large proportion of all health services supplied nationwide, particularly charity care, these shortcomings have had serious repercussions. The central issue addressed in this Article is how fidelity to the mission of the charitable health care corporation should be monitored. It advances the normative perspective that the law should maximize opportunities for nonprofits to fulfill their charitable missions, but should insist on more than nebulous assurances that society will receive tangible benefits. For nonprofit corporate doctrine, this Article proposes that nonprofit corporate law incorporate a principle of "mission primacy" - a doctrinal recognition that the nonprofit corporation's articulated charitable mission is its central objective.

Recommended Citation

Greaney, Thomas L. and Boozang, Kathleen M., Mission, Margin, and Trust in the Nonprofit Health Care Enterprise (December 23, 2004). Yale Journal of Health Policy, Law, and Ethics, Vol. 31, 2004.