Court Opinion

ID: 9529258
Source: CourtListenerOpinion
Date Created: 2023-08-07 03:49:13.402974+00
Date Added: 2024-06-11T13:27:43.128672
License: Public Domain

JUSTICE DUNN, dissenting: I respectfully dissent. I would find that plaintiff is entitled to a partial exemption for the Immediate Care Center and the community and exercise rooms. The majority concludes that the Immediate Care Center is not exclusively used for charitable purposes and is therefore not entitled to an exemption. This conclusion is reached because all patients are billed for the treatments they receive, the advertisements for the Center do not state that free care is available, and only 6% of the care provided in 1982 was free care. Those facts, however, do not alter the charitable character of the Immediate Care Center. The fact that only 6% of the Immediate Care Center’s total billing for 1982 was provided as free care is not a sufficient basis on which to deny the requested exemption. The argument that a provider of health care services should not be held to be an institution of public charity where those who pay for their care greatly outnumber charity patients was rejected by our supreme court in Sisters of Third Order of St. Francis v. Board of Review (1907), 231 Ill. 317, 83 N.E. 272. The court there characterized such argument as “without merit, so long as charity was dispensed to all those who needed it and who applied therefor, and so long as no private gain or profit came to any person connected with the institution, and so long as it does not appear that any obstacle, of any character, was by the corporation placed in the way of those who might need charity of the kind dispensed by this institution, calculated to prevent such persons making application to or obtaining admission to the hospital.” (Emphasis added.) 231 Ill. 317, 322, 83 N.E. 272. Although recognizing that it is not the percentage of free care which determines the right to exemption, the majority holds that the Immediate Care Center is not charitable because it does not advertise the availability of free care and because payment is expected, at least initially, from all patients. The majority holding has thus inserted a new requirement for charitable exemption: the availability of free care must be advertised to the public. Having examined the cases which set forth the requirements for a charitable exemption, however, I note no such requirement, and I would decline to now impose that unprecedented burden on this not-for-profit medical provider. Nor does the Immediate Care Center’s billing procedure impose an impermissible obstacle between the provision of care and those needing treatment. While all patients are billed for their treatment, all patients are treated before receiving a bill. There is no differentiation made in treatment afforded between those who eventually pay and those who cannot. It seems that because of the outpatient type of medical care dispensed at the Immediate Care Center, financial screening is not available prior to treatment. Instead, a decision regarding ability to pay is made after treatment is rendered and a bill sent. If a patient can then show inability to pay, collection proceedings stop. While financial screening prior to treatment may be feasible in an inpatient setting, the methods employed by the Immediate Care Center are a reasonable attempt to collect payment from those who are able to pay. In People ex rel. Cannon v. Southern Illinois Hospital Corp. (1949), 404 Ill. 66, 88 N.E. 20, it was also argued that the hospital was not entitled to an exemption due to its manner of admitting patients who were unable to pay for hospital services. When an elective patient presented himself for treatment, the hospital required a week’s board in advance. If a patient could not make such payment, he was asked to wait until an investigation was made to see if he was eligible for relief and arrangements were made with the proper relief agency for payment. (404 Ill. 66, 72, 88 N.E. 20.) Although the trial judge found the waiting period to be a disqualifying obstacle, the supreme court did not agree, noting, “Sound business dictates that hospitals inquire into the ability of a prospective patient to pay, and it is the generally accepted practice of all hospitals.” (404 Ill. 66, 73, 88 N.E. 20.) In contrast, the Immediate Care Center requires no waiting period or prepayment for services. While the Southern Illinois Hospital investigated elective patients’ abilities to pay before treatment, the Immediate Care Center renders treatment first and then determines through their billing procedures whether patients are able to pay. By providing care before financial screening, the Immediate Care Center imposes less of an obstacle than the waiting period of Southern Illinois Hospital. The majority would distinguish Sisters of St. Francis and Southern Illinois Hospital from the instant plaintiff on the basis that the former were set up primarily for charitable purposes. It seems to me, however, that plaintiff, too, was organized primarily for a charitable purpose and, in that respect, is no different than the aforementioned medical facilities. Previous decisions have set forth the distinctive characteristics of a charitable institution. A charitable institution “has no capital, capital stock or shareholders, earns no profits or dividends, but rather derives its funds from public and private charity and holds them in trust for the objects and purposes expressed in its charter.” (Methodist Old Peoples Home v. Korzen (1968), 39 Ill. 2d 149, 157, 233 N.E.2d 537.) As noted above, a charitable institution dispenses charity to all who need and apply for it, does not provide gain or profit in a private sense to any person connected with it, and does not place obstacles of any character in the way of those who need and would avail themselves of the benefits it dispenses. (Sisters of Third Order of St. Francis v. Board of Review (1907), 231 Ill. 317, 322, 83 N.E. 272.) Furthermore, hospitals have been held to be charitable organizations “provided all funds received by the hospital are devoted to its charitable purpose and no part of the money received by it is permitted to inure to the benefit of any private individual engaged in managing the charity.” People ex rel. Cannon v. Southern Illinois Hospital Corp. (1949), 404 Ill. 66, 69-70, 88 N.E.2d 20. Highland Park Hospital acquired title to the property in question on December 21, 1979. The hospital is organized as a not-for-profit corporation. The hospital’s articles of incorporation provide that the purposes of the corporation are to establish medical facilities and to carry on its activities exclusively for charitable, scientific, and educational purposes in a manner that no earnings inure to any trustee, officer, or individual. In 1982, the directors of the hospital formed five corporations to provide flexibility and protection of assets for the total organization. The parent corporation is Lakeland Health Services Corporation, which establishes policy and oversees the operations of the subsidiaries. The board of that corporation is identical to the board of the hospital. The hospital continues to function as it has in the past, providing health services at the hospital location. The Highland Park Hospital Foundation was formed to raise funds for the health care services. Groveland Properties, Inc., is a real estate holding company whose purpose is to manage any property acquisitions. The property in question is presently the only property owned by Groveland. Any funds received by Groveland in managing the property in excess of operating costs are turned over to the Highland Park Hospital Foundation. The hospital also obtains funds from patient revenues, from contributions from the community, and from the Federal government. All of the corporations are not-for-profit and enjoy tax-exempt status from the United States Treasury Department. It is apparent that the financial structure, policy of remuneration of officers and directors, application of fees collected, and the method and purpose of operation typify plaintiffs as charitable institutions under the principles set forth above. It is of no consequence that title to the property in question is held by Groveland rather than the hospital itself. This mode of holding title is merely an attempt to more efficiently implement the overall corporate purpose. “If ways of doing things have become outmoded or replaced by more efficient and realistic methods of management, the law will look to the substance, not to mere forms.” Association of American Medical Colleges v. Lorenz (1959), 17 Ill. 2d 125, 129, 160 N.E.2d 763. I would also hold that plaintiffs are entitled to an exemption for the community and exercise rooms. The community room, which can accommodate 40 to 50 people, is open to residents of the community and recognized community groups for programs and meetings, at no charge. The hospital also conducts a series of health eduction programs, including classes in cardiopulmonary resuscitation and first aid, at no cost except for some small materials charges. Physicians conduct a lecture series in the room covering various health-related topics. The lectures are free ánd open to the public. The exercise room has a dual purpose. It is available to patients of the building’s physicians at no cost. The room is also used by the Hospital to conduct exercise programs, weight control programs, and aerobic classes. These programs are open to the public and are free, with the exception of a small fee to pay for an outside aerobics instructor. Neither the community room nor the exercise room produces any income for the hospital. The Department of Revenue and the majority determined that neither room qualified for a charitable exemption. While recognizing that the public may benefit from the lectures and classes, both the Department and the majority found that the use of the rooms did not fulfill a major criterium for charitable use, i.e., that a burden of government is relieved. It is true that relief of a government burden is an essential element of a charitable use. “The reason for exemptions in favor of charitable institutions is the benefit conferred upon the public by them, and a consequent relief, to some extent, of the burden upon the State to care for and advance the interests of its citizens.” (Emphasis added.) (People v. YMCA (1937), 365 Ill. 118, 122, 6 N.E.2d 166.) Thus, plaintiffs must show some relief of a government burden to qualify for exemption. The hearing officer noted that provision of health care lectures, aerobics, and exercise programs is not an obligation of government. It seems here, however, that the Department employed too narrow a focus in determining whether a government burden has been relieved by the use of the community and exercise rooms. This requirement is not so stringent as to exclude programs whose goal is to avert a need for' government assistance. In holding that the YMCA of Chicago was entitled to a charitable exemption, the Illinois Supreme Court quoted with approval Commonwealth v. YMCA (1903), 116 Ky. 711, 76 S.W. 522, where it was stated of the charitable nature of the association’s work: “It is not so much the giving of alms or in aid of the mendicant; the endeavor is to reach the boys and young men before they need alms and before they are reduced to beggary, and by training their minds and teaching them how to use and preserve their bodies ***.” (Emphasis added.) People v. YMCA (1937), 365 Ill. 118, 123, 6 N.E.2d 166. Here, too, plaintiffs’ use of the community room and exercise room is designed to prevent burdens on government. By teaching the public how to be more healthy, and by providing the public with the equipment with which to implement that knowledge, plaintiffs are using their property in a way which lessens to some extent the burden of government to advance the interest of its citizens. (See, e.g., American College of Surgeons v. Korzen (1967), 36 Ill. 2d 340, 348-49, 224 N.E.2d 7.) As the saying goes, an ounce of prevention is worth a pound of cure. Although the majority holds that plaintiffs have not shown the primary use of the exercise room is charitable because no data concerning public use was offered, I would find that plaintiffs have met their burden of proof. There was adequate testimony that the room was extensively used by residents of Long Grove, as well as by residents of neighboring communities. In denying the exemption, the majority notes that the exercise room is on the second floor of the building so that easy access to the general public is not obtained. That argument is “make weight.” I fail to see how one flight of stairs or the need to ride an elevator one floor constitutes a barrier to easy public access. In conclusion, I would find that plaintiffs are entitled to a partial exemption for the Immediate Care Center and the community and exercise rooms. For the foregoing reasons, I respectfully dissent.